Acute Stroke Unit, Metropolitan Hospital, Piraeus, Greece.
Department of Clinical Neurophysiology, Metropolitan Hospital, Piraeus, Greece.
J Neuroimaging. 2018 May;28(3):239-251. doi: 10.1111/jon.12495. Epub 2018 Jan 15.
Carotid artery disease (CAD) is a common cause of ischemic stroke with high rates of recurrence. Carotid endarterectomy (CEA) or carotid artery stenting (CAS) are highly recommended for the secondary prevention of symptomatic CAD during the first 14 days following the index event of transient ischemic attack or minor stroke. CEA or CAS may also be offered in selected cases with severe asymptomatic stenosis. Herein, we review the utility of neurosonology in the diagnosis and pre-/peri-interventional assessment of CAD patients who undergo carotid revascularization procedures. Carotid ultrasound may provide invaluable information on plaque echogenicity, ulceration, risk of thrombosis, and rupture. Transcranial Doppler or transcranial color-coded sonography may further assist by mapping collateral circulation, evaluating the impairment of vasomotor reactivity, detecting microembolization, or reperfusion hemorrhage in real time. Neurosonology examinations are indispensable bedside tools assisting in the diagnosis, risk stratification, peri-interventional monitoring, and follow-up of patients with CAD.
颈动脉疾病（CAD）是缺血性中风的常见病因，复发率较高。对于症状性 CAD 患者，在短暂性脑缺血发作或小卒中的指数事件后 14 天内，强烈推荐进行颈动脉内膜切除术（CEA）或颈动脉支架置入术（CAS）以进行二级预防。在某些严重无症状狭窄的情况下，也可以选择 CEA 或 CAS。在此，我们回顾了神经超声在接受颈动脉血运重建的 CAD 患者的诊断和术前/围手术期评估中的作用。颈动脉超声可提供斑块回声、溃疡、血栓形成和破裂风险的宝贵信息。经颅多普勒或经颅彩色编码超声可以通过映射侧支循环、评估血管舒缩反应受损、实时检测微栓塞或再灌注出血来进一步辅助诊断。神经超声检查是协助诊断、风险分层、围手术期监测和 CAD 患者随访的不可或缺的床边工具。
