Online Neurology Days | Day 1 - August 24, 2021, 19:00 (CET) / 13:00 (EST)

Stroke Symptoms | Ultrasound

Globally, stroke is a leading cause of mortality and disability with the World Stroke Organization reporting an annual mortality rate of 5 and a half million people*. Additionally, up to 50% of survivors have chronic disability posing a major public health problem and substantial economic burden. Identifying who is at risk of stroke remains a high priority according to the US Preventive Services Task Force**. In this lecture, you will see how carotid ultrasound and the use of Superb Microvascular Imaging in carotid artery plaques play a role in risk stratification

*https://www.world-stroke.org/assets/downloads/WSO_Fact-sheet_15.01.2020.pdf
**https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2775733

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Program
  • Ultrasound imaging of the carotid artery in stroke assessment - Prof. Neil D. Pugh
  • Detection of neovascularization with advanced ultrasound method (SMI) without using contrast material - Dr. Mahtab Zamani
  • Live Q&A

Why should you attend?
  1. Get an update about the standard diagnostic criteria in stroke assessment.
  2. Learn more about the early detection of vascular disease.
  3. Understand the diagnostic relevance of detecting neovascularization in unstable plaques by the use of SMI.

EXTENSIVE INFORMATION ON SPEAKER AND THEIR PRESENTATIONS

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Speaker: Prof. Neil D. Pugh, MSc, PhD
Prof. of Clinical Engineering
Honorary Visiting Professor School of Engineering at Cardiff University
Cardiff University, Spire Hospital Cardiff
Cardiff, UK

Having read Physics at the University of Wales, Swansea Professor Pugh moved to Manchester. He completed his MSc at Leeds University before returning to South Wales in 1985, following that he completed a PhD thesis investigating the vasodilatory effects of x-ray contrast media. Professor Pugh worked as a consultant medical physicist and head of non-ionising radiation at the University Hospital of Wales, Cardiff. Prof. Pugh is still actively involved in vascular and gynaecological ultrasound scanning. In addition, he still teaches in the UK and overseas and is still actively involved in research at Cardiff University. He has supervised numerous PhD students, completing their theses in ultrasound applications and still supervises one PhD student at Cardiff University. He is also the current past president of the British Society for Gynaecological Imaging.

Presentation title: Ultrasound imaging of the carotid artery in stroke assessment

This session will look at the scope of the problem and its association with carotid artery disease, moving on to present the diagnostic criteria for assessing the condition. The use of ultrasound imaging as part of the patient pathway will be discussed, including consideration of haemodynamics. The session will also cover pitfalls and cautions of ultrasound scanning and interpretation, with a finally summary of conclusions.

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Speaker: Dr. Mahtab Zamani, MD
PhD Candidate specialisation neurology
Oslo University Hospital Rikshospitalet
Oslo, Norway

Under PhD program at University of Oslo and Neurology department, Oslo University Hospital, Rikshospitalet since 2018. Dr. Zamani’s PhD project is a prospective multimodal study on advanced ultrasound methods in assessment of carotid plaque instability in collaboration with department of Radiology, Pathology and Cardiothoracic Surgery.
Dr. Zamani is a Neurology resident at Neurology department, Rikshospitalet and since 2018 involved in clinical research, emergency treatment of ischemic stroke patients and outpatient clinic (cerebrovascular lab).

Presentation title: Detection of neovascularization with advanced ultrasound method (SMI) without using contrast material

A significant proportion of ischemic strokes are caused by an emboli from an unstable atherosclerotic carotid artery plaque. Intraplaque neovascularization (IPN) plays a key role in plaque instability. Conventional Doppler ultrasound cannot detect IPN, partly due to application of motion wall filter in order to remove clutter. Contrast-enhanced ultrasound (CEUS) can detect IPN, but it requires an intravenous injection of contrast material. Superb microvascular imaging (SMI) however uses an algorithm to remove clutter and motion wall artefacts while preserving low-velocity blood flow as such seen in IPN, without the use of contrast material. Allowing visualization of IPN. The aim of the study included in this presentation was to assess the feasibility of SMI as a bedside non-invasive method for detection of IPN.

Scient⁠ific Evidence Stroke Symptoms, Day 1

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Ultrasound
Zamani et al. | Carotid Plaque Neovascularization Detected With Superb Microvascular Imaging Ultrasound Without Using Contrast Media | Stroke (2019)
https://pubmed.ncbi.nlm.nih.gov/31510899/

Sato et al. | Visualization of arterial wall vascularization using superb microvascular imaging in active-stage Takayasu arteritis | European Heart Journal Cardiovascular Imaging (2019)
https://pubmed.ncbi.nlm.nih.gov/30668654/

Zhang et al. | Comparison of diagnostic values of ultrasound micro-flow imaging and contrast-enhanced ultrasound for neovascularization in carotid plaques | Experimental and Therapeutic Medicine (2017)
https://pubmed.ncbi.nlm.nih.gov/28672985/

Ishikawa et al. | Ultrasonography Monitoring with Superb Microvascular Imaging Technique in Brain Tumor Surgery | World Neurosurgery (2016)
https://pubmed.ncbi.nlm.nih.gov/27989976/

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