Made available in DSpace on 2017-07-21T14:13:05Z (GMT). No. of bitstreams: 1 Clarissa Elize.pdf: 4457240 bytes, checksum: d8f2520757eb456c2ae4c01f7a1f0343 (MD5) Previous issue date: 2015-12-21 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Skin wounds are interruptions of the normal physiological and anatomical structure of the skin causing damage by loss of barrier function becoming the organism exposed to various types of substances and microorganisms. A fast healing of the wound is essential to avoid the risk of infections and other complications. The aim of this work was to the development of lipid nanoparticles, as solid lipid nanoparticles and lipid-core polymeric nanoparticles containing halcinonide to modulate the inflammatory phase of wound healing, reducing pain, discomfort, edema, exudates and to reduced the drug toxicity. To this end, nanoparticles were obtained and characterized for particle size, physicochemical properties, stability, encapsulation efficiency, scanning electron microscopy by field emission, x-ray diffraction, spectroscopy in the infrared and Raman Fourier Transform, differential scanning calorimetry, thermal gravimetric analysis, study of the in vitro skin permeation and in vivo evaluation of the inflammatory response and drug toxicity. Furthermore, a highperformance liquid chromatography method for quantification of the drug was developed and validated. Nanoparticles had an average diameter ranging from 260-500 nm, polydispersity index below 0.37, zeta potential close to -30 mV, pH between 5.3 and 6.5 and were stability after storage for 60 days. The microscopy images showed spherical shape with smooth surface. The X-ray diffraction analysis showed drug amorphization in the nanostructured systems. By infrared and Raman spectroscopy was identified the characteristic bands of main components of the formulations, indicating no chemical bonding between them. Thermal analysis revealed the melting peaks of the drug and lipids and polymer and the temperature of its degradation. Nanoparticles showed 5.0% of drug permeation in 24 hours. In vivo study showed that the pure halcinonide was toxic; producing systemic adverse effects and nanoparticles containing the drug was able to modulate the inflammation healing, avoiding the edema and exudates formation and however impairing the subsequent stages of the healing process. However, the incorporation of the halcinonide in nanoparticles was able to reduce the drug toxicity due to the control of the drug release. Regarding the samples of lipid nanoparticles, both showed similar results, wherein the lipid-core polymeric nanoparticles showed better retraction of the wound and macroscopic appearance, possibly due to the polymer control associated with the lipid in halcinonide release. / Lesões cutânea são interrupções da sua estrutura anatômica normal e fisiológica que causam danos pela perda da função barreira da pele tornando-a exposta a diversos tipos de substâncias e microrganismos. Dessa forma uma rápida cicatrização desta lesão é fundamental para evitar o risco de infecções e outras complicações. O objetivo deste trabalho foi o desenvolvimento de nanopartículas lipídicas, na forma de nanopartículas lipídicas sólidas e nanopartículas poliméricas de núcleo lipídico, para veiculação de halcinonida para modulação da fase inflamatória da cicatrização, reduzindo dor, desconforto, edema e exsudato, aliado a redução da toxicidade do fármaco. Para tanto, as nanopartículas foram obtidas e caracterizadas quanto ao tamanho de partícula, propriedades físico-químicas, estabilidade, eficiência de encapsulação do fármaco, microscopia eletrônica de varredura por emissão de campo, difração de raios x, espectroscopia na região do infravermelho e Raman com Transformada de Fourier, calorimetria diferencial de varredura, análise termogravimétrica, estudo de permeação cutânea in vitro e avaliação in vivo da resposta inflamatória e da toxicidade do fármaco. Além disso, um método para quantificação do fármaco por cromatografia líquida de alta eficiência foi desenvolvido e validado. As nanopartículas apresentaram diâmetro médio variando entre 260 a 500 nm, índice de polidispersão abaixo de 0,37, potencial zeta próximo a -30 mV, pH entre 5,3 e 6,5 e apresentaram estabilidade após armazenamento de 60 dias. As imagens obtidas por microscopia revelaram formato esférico com superfície lisa. A análise de difração de raios x demonstrou a amorfização do fármaco nos sistemas nanoestruturados. Por espectroscopia na região do infravermelho e Raman puderam-se identificar as bandas características dos principais componentes das formulações, indicando que não houve ligação química entre eles. A análise térmica revelou os picos da fusão do fármaco e dos lipídeos e polímero utilizados e a temperatura da sua degradação. As nanopartículas apresentaram 5,0 % do fármaco permeado em 24 horas de estudo. O estudo in vivo revelou que a halcinonida livre foi tóxica, produzindo efeitos adversos sistêmicos e as nanopartículas contendo o fármaco foram capazes de modular a inflamação da cicatrização, evitando a formação de edema e exsudato, porém prejudicando as fases subsequentes do processo de cicatrização. No entanto, a incorporação da halcinonida nas nanopartículas foi capaz de reduzir a toxicidade do fármaco pelo controle da sua liberação. Em relação às amostras, as duas nanopartículas desenvolvidas apresentaram resultados semelhantes,sendo que as nanopartículas poliméricas de núcleo lipídico mostrou melhor retração da ferida e aspecto macroscópico, possivelmente pelo controle polimérico associado ao do lipídeo para liberação da halcinonida.

Η αθηροσκλήρυνση είναι μια παθολογική διαδικασία η οποία λαμβάνει χώρα στις μεγάλες αρτηρίες και αποτελεί την υποκείμενη αιτία καρδιαγγειακών συμβαμάτων, εγκεφαλικών επεισοδίων και περιφερικής αρτηριακής νόσου. Η τυπική αθηροσκληρυντική βλάβη αποτελείται από έναν λιπιδικό πυρήνα που καλύπτεται από ινώδες περίβλημα. Ορισμένοι «ευάλωτοι» ασθενείς εμφανίζουν σε μεγάλο ποσοστό τις λεγόμενες «ασταθείς» βλάβες. Αυτές είναι αλλοιώσεις που έχουν την τάση να ρήγνυνται με αποτέλεσμα το σχηματισμό θρόμβου ο οποίος μερικά ή ολικά αποφράσσει την κυκλοφορία. Στην εργασία αυτή μελετώνται η παθοφυσιολογία του φαινομένου και οι παράγοντες που σχετίζονται με την τοπική και συστηματική βιολογία και συμμετέχουν στην αστάθεια και ρήξη της πλάκας. / Atherosclerosis is a pathological process that takes place in the large arteries and constitutes the amenable cause of cardiovascular events, cerebrovascular accidents and peripheral arterial disease. The typical atherosclerotic lesion is constituted by ljpid core that is covered by fibrous cap. Certain \"sensitive\" patients have the predisposition to develop the so - called \"unstable\" lesions. These are alterations that have the tendency to rupture resulting to the formation of clot which occludes the vessel partially or totally. This work studies the pathophysiology of phenomenon and the factors that are related with the local and systematic biology and participate in the instability and rupture of plaque.

Neste trabalho foi avaliada a permeação/penetração cutânea in vitro (pele suína) de propionato de clobetasol nanoencapsulado incorporado em um semissólido, empregando células de difusão de Franz. A nanoencapsulação foi capaz de reduzir a quantidade de fármaco que penetra nas camadas da pele (estrato córneo, epiderme e derme) sem alterar a forma (distribuição percentual) como o propionato de clobetasol se distribui. A adequabilidade de diferentes membranas sintéticas (acetato de celulose, policarbonato e membrana de diálise) para a avaliação da liberação in vitro, empregando células de difusão de Franz, a partir desta formulação foi também estudada. A partir da combinação de diferentes técnicas analíticas (espalhamento de luz dinâmica, microscopias eletrônicas de transmissão e varredura) foi observado que a membrana de menor tamanho de poro (membrana de diálise, 12 kDa de cut off) é a mais adequada para a condução deste tipo de avaliação, pois é a única capaz de evitar a passagem de nanocápsulas íntegras da formulação para o meio receptor das células de difusão, em detrimento das membranas de policarbonato e acetato de celulose (0,05 μm e 0,45 μm de tamanho de poro, respectivamente). Além disso, uma nova estratégia para a avaliação da liberação in vitro de fármacos associados a nanocápsulas de núcleo lipídico, combinando fluxo contínuo de meio de liberação e sacos de diálise foi proposta neste trabalho. A técnica mostrou-se adequada para a obtenção do perfil de liberação in vitro a partir de suspensões de nanocápsulas contendo diferentes fármacos modelo (prednisolona e propionato de clobetasol), possibilitando a diferenciação destes sistemas de soluções contendo os fármacos livres, graficamente e pelos valores de fluxo calculados. Adicionalmente, esta estratégia mostrou-se apropriada para a manutenção da concentração de fármaco no meio de liberação afastada da saturação, contribuindo para o atendimento da condição sink. Ainda, classificamos o sistema como um protótipo semi-automatizado para a avaliação da liberação in vitro de fármacos, capaz de gerar resultados com maior precisão em relação à diálise convencional. / The in vitro cutaneous permeation/penetration (porcine skin) of clobetasol propionate-loaded lipid-core nanocapsules incorporated into a semisolid dosage form was evaluated, using the Franz diffusion cells technique. It was shown that the nanoencapsulation was able to reduce the drug amount penetration into skin layers (stratum corneum, epidermis and dermis) without changing the way (percentual distribution) that it was distributed. The suitability of different synthetic membranes (cellulose acetate, polycarbonate, and dialysis membrane) to assess the in vitro drug release using Franz diffusion cells from this formulation was also studied. It was ascertained by combining different analytical techniques (dynamic light scattering, scanning and transmition electron microscopy) that the membrane with smaller pore size (dialysis membrane, 12 kDa cut off) is the most appropriate for conducting this kind of study, because it is the only one able of preventing the passage of intact nanocapsules from formulation to Franz diffusion cells receptor media, instead of polycarbonate and cellulose acetate membranes (0.05 and 0.45 pore size, respectively). In addition, a new strategy to assess in vitro drug release drug-loaded lipid-core nanocapsules was proposed, associating continuous flow of release media and dialysis sac. The proposed system was adequate to assess the in vitro drug release profiles from nanocapsule suspensions containing different model drugs (prednisolone and clobetasol propionate), enabling the differentiation of these systems from drug solutions, graphically and by the calculated flux values. Furthermore, this strategy was suitable to maintain the drug concentration into release media far away from saturation, contributing to the sink condition. Also, the proposed system was described as a semi-automated prototype for in vitro drug release evaluation, able to produce results with greater accuracy than conventional dialysis technique.

Neste trabalho foi avaliada a permeação/penetração cutânea in vitro (pele suína) de propionato de clobetasol nanoencapsulado incorporado em um semissólido, empregando células de difusão de Franz. A nanoencapsulação foi capaz de reduzir a quantidade de fármaco que penetra nas camadas da pele (estrato córneo, epiderme e derme) sem alterar a forma (distribuição percentual) como o propionato de clobetasol se distribui. A adequabilidade de diferentes membranas sintéticas (acetato de celulose, policarbonato e membrana de diálise) para a avaliação da liberação in vitro, empregando células de difusão de Franz, a partir desta formulação foi também estudada. A partir da combinação de diferentes técnicas analíticas (espalhamento de luz dinâmica, microscopias eletrônicas de transmissão e varredura) foi observado que a membrana de menor tamanho de poro (membrana de diálise, 12 kDa de cut off) é a mais adequada para a condução deste tipo de avaliação, pois é a única capaz de evitar a passagem de nanocápsulas íntegras da formulação para o meio receptor das células de difusão, em detrimento das membranas de policarbonato e acetato de celulose (0,05 μm e 0,45 μm de tamanho de poro, respectivamente). Além disso, uma nova estratégia para a avaliação da liberação in vitro de fármacos associados a nanocápsulas de núcleo lipídico, combinando fluxo contínuo de meio de liberação e sacos de diálise foi proposta neste trabalho. A técnica mostrou-se adequada para a obtenção do perfil de liberação in vitro a partir de suspensões de nanocápsulas contendo diferentes fármacos modelo (prednisolona e propionato de clobetasol), possibilitando a diferenciação destes sistemas de soluções contendo os fármacos livres, graficamente e pelos valores de fluxo calculados. Adicionalmente, esta estratégia mostrou-se apropriada para a manutenção da concentração de fármaco no meio de liberação afastada da saturação, contribuindo para o atendimento da condição sink. Ainda, classificamos o sistema como um protótipo semi-automatizado para a avaliação da liberação in vitro de fármacos, capaz de gerar resultados com maior precisão em relação à diálise convencional. / The in vitro cutaneous permeation/penetration (porcine skin) of clobetasol propionate-loaded lipid-core nanocapsules incorporated into a semisolid dosage form was evaluated, using the Franz diffusion cells technique. It was shown that the nanoencapsulation was able to reduce the drug amount penetration into skin layers (stratum corneum, epidermis and dermis) without changing the way (percentual distribution) that it was distributed. The suitability of different synthetic membranes (cellulose acetate, polycarbonate, and dialysis membrane) to assess the in vitro drug release using Franz diffusion cells from this formulation was also studied. It was ascertained by combining different analytical techniques (dynamic light scattering, scanning and transmition electron microscopy) that the membrane with smaller pore size (dialysis membrane, 12 kDa cut off) is the most appropriate for conducting this kind of study, because it is the only one able of preventing the passage of intact nanocapsules from formulation to Franz diffusion cells receptor media, instead of polycarbonate and cellulose acetate membranes (0.05 and 0.45 pore size, respectively). In addition, a new strategy to assess in vitro drug release drug-loaded lipid-core nanocapsules was proposed, associating continuous flow of release media and dialysis sac. The proposed system was adequate to assess the in vitro drug release profiles from nanocapsule suspensions containing different model drugs (prednisolone and clobetasol propionate), enabling the differentiation of these systems from drug solutions, graphically and by the calculated flux values. Furthermore, this strategy was suitable to maintain the drug concentration into release media far away from saturation, contributing to the sink condition. Also, the proposed system was described as a semi-automated prototype for in vitro drug release evaluation, able to produce results with greater accuracy than conventional dialysis technique.

Neste trabalho foi avaliada a permeação/penetração cutânea in vitro (pele suína) de propionato de clobetasol nanoencapsulado incorporado em um semissólido, empregando células de difusão de Franz. A nanoencapsulação foi capaz de reduzir a quantidade de fármaco que penetra nas camadas da pele (estrato córneo, epiderme e derme) sem alterar a forma (distribuição percentual) como o propionato de clobetasol se distribui. A adequabilidade de diferentes membranas sintéticas (acetato de celulose, policarbonato e membrana de diálise) para a avaliação da liberação in vitro, empregando células de difusão de Franz, a partir desta formulação foi também estudada. A partir da combinação de diferentes técnicas analíticas (espalhamento de luz dinâmica, microscopias eletrônicas de transmissão e varredura) foi observado que a membrana de menor tamanho de poro (membrana de diálise, 12 kDa de cut off) é a mais adequada para a condução deste tipo de avaliação, pois é a única capaz de evitar a passagem de nanocápsulas íntegras da formulação para o meio receptor das células de difusão, em detrimento das membranas de policarbonato e acetato de celulose (0,05 μm e 0,45 μm de tamanho de poro, respectivamente). Além disso, uma nova estratégia para a avaliação da liberação in vitro de fármacos associados a nanocápsulas de núcleo lipídico, combinando fluxo contínuo de meio de liberação e sacos de diálise foi proposta neste trabalho. A técnica mostrou-se adequada para a obtenção do perfil de liberação in vitro a partir de suspensões de nanocápsulas contendo diferentes fármacos modelo (prednisolona e propionato de clobetasol), possibilitando a diferenciação destes sistemas de soluções contendo os fármacos livres, graficamente e pelos valores de fluxo calculados. Adicionalmente, esta estratégia mostrou-se apropriada para a manutenção da concentração de fármaco no meio de liberação afastada da saturação, contribuindo para o atendimento da condição sink. Ainda, classificamos o sistema como um protótipo semi-automatizado para a avaliação da liberação in vitro de fármacos, capaz de gerar resultados com maior precisão em relação à diálise convencional. / The in vitro cutaneous permeation/penetration (porcine skin) of clobetasol propionate-loaded lipid-core nanocapsules incorporated into a semisolid dosage form was evaluated, using the Franz diffusion cells technique. It was shown that the nanoencapsulation was able to reduce the drug amount penetration into skin layers (stratum corneum, epidermis and dermis) without changing the way (percentual distribution) that it was distributed. The suitability of different synthetic membranes (cellulose acetate, polycarbonate, and dialysis membrane) to assess the in vitro drug release using Franz diffusion cells from this formulation was also studied. It was ascertained by combining different analytical techniques (dynamic light scattering, scanning and transmition electron microscopy) that the membrane with smaller pore size (dialysis membrane, 12 kDa cut off) is the most appropriate for conducting this kind of study, because it is the only one able of preventing the passage of intact nanocapsules from formulation to Franz diffusion cells receptor media, instead of polycarbonate and cellulose acetate membranes (0.05 and 0.45 pore size, respectively). In addition, a new strategy to assess in vitro drug release drug-loaded lipid-core nanocapsules was proposed, associating continuous flow of release media and dialysis sac. The proposed system was adequate to assess the in vitro drug release profiles from nanocapsule suspensions containing different model drugs (prednisolone and clobetasol propionate), enabling the differentiation of these systems from drug solutions, graphically and by the calculated flux values. Furthermore, this strategy was suitable to maintain the drug concentration into release media far away from saturation, contributing to the sink condition. Also, the proposed system was described as a semi-automated prototype for in vitro drug release evaluation, able to produce results with greater accuracy than conventional dialysis technique.

Atherosclerotic diseases including stroke are the leading causes of morbidity, mortality as well as disability in industrialized countries. Carotid endarterectomy was long considered the stan- dard approach for the treatment of atherosclerotic carotid disease, one of major causes of stroke. Over time, carotid artery stenting (CAS) has evolved as an alternative approach and is considered equivalent to surgical treatment in selected patients. Particularly in the last years, CAS has gained attention with the increasing knowledge regarding atherosclerotic plaque and cerebrovascular flow. In our study, we focused on patients undergoing CAS and evaluated structural and hemodynamic characteristics of atherosclerotic plaques together with relation to endovascular manipulation. The major part of the study includes transcranial doppler ultrasound evaluation which is able to detect flow in major cerebral arteries as well as to detect microembolizations of atherosclerotic particles during CAS. In eligible patients, we investigated the usefulness of cerebrovascular reserve (CVR) testing to predict severe hemodynamic changes in ipsilateral middle cerebral artery induced by temporary carotid occlusion during proximally protected CAS. CVR was tested by means of a breath-holding test and ophthalmic artery flow...

L’accident vasculaire cérébral (AVC) est une cause principale de décès et de morbidité dans le monde; une bonne partie des AVC est causée par la plaque d’athérosclérose carotidienne. La prévention de l’AVC chez les patients ayant une plaque carotidienne demeure controversée, vu les risques et bénéfices ambigus associés au traitement chirurgical ou médical. Plusieurs méthodes d’imagerie ont été développées afin d’étudier la plaque vulnérable (dont le risque est élevé), mais aucune n’est suffisamment validée ou accessible pour permettre une utilisation comme outil de dépistage. L’élastographie non-invasive vasculaire (NIVE) est une technique nouvelle qui cartographie les déformations (élasticité) de la plaque afin de détecter les plaque vulnérables; cette technique n’est pas encore validée cliniquement. Le but de ce projet est d’évaluer la capacité de NIVE de caractériser la composition de la plaque et sa vulnérabilité in vivo chez des patients ayant des plaques sévères carotidiennes, en utilisant comme étalon de référence, l’imagerie par résonance magnétique (IRM) à haute-résolution. Afin de poursuivre cette étude, une connaissance accrue de l’AVC, l’athérosclérose, la plaque vulnérable, ainsi que des techniques actuelles d’imagerie de la plaque carotidienne, est requise. Trente-et-un sujets ont été examinés par NIVE par ultrasonographie et IRM à haute-résolution. Sur 31 plaques, 9 étaient symptomatiques, 17 contenaient des lipides, et 7 étaient vulnérables selon l’IRM. Les déformations étaient significativement plus petites chez les plaques contenant des lipides, avec une sensibilité élevée et une spécificité modérée. Une association quadratique entre la déformation et la quantité de lipide a été trouvée. Les déformations ne pouvaient pas distinguer les plaques vulnérables ou symptomatiques. En conclusion, NIVE par ultrasonographie est faisable chez des patients ayant des sténoses carotidiennes significatives et peut détecter la présence d’un coeur lipidique. Des études supplémentaires de progression de la plaque avec NIVE sont requises afin d’identifier les plaques vulnérables. / Stroke is a leading cause of death and morbidity worldwide, and a significant proportion of strokes are caused by carotid atherosclerotic plaque rupture. Prevention of stroke in patients with carotid plaque poses a significant challenge to physicians, as risks and benefits of surgical or medical treatments remain equivocal. Many imaging techniques have been developed to identify and study vulnerable (high-risk) atherosclerotic plaques, but none is sufficiently validated or accessible for population screening. Non-invasive vascular elastography (NIVE) is a novel ultrasonic technique that maps carotid plaque strain (elasticity) characteristics to detect its vulnerability; it has not been clinically validated yet. The goal of this project is to evaluate the ability of ultrasound NIVE strain analysis to characterize carotid plaque composition and vulnerability in vivo in patients with significant plaque burden, as determined by the reference standard, high resolution MRI. To undertake this study, a thorough understanding of stroke, atherosclerosis, vulnerable plaque, and current non-invasive carotid plaque imaging techniques is required. Thirty-one subjects underwent NIVE and high-resolution MRI of internal carotid arteries. Of 31 plaques, 9 were symptomatic, 17 contained lipid and 7 were vulnerable on MRI. Strains were significantly lower in plaques containing a lipid core compared to those without lipid, with high sensitivity and moderate specificity. A quadratic fit was found between strain and lipid content. Strains did not discriminate symptomatic patients or vulnerable plaques. In conclusion, ultrasound NIVE is feasible in patients with significant carotid stenosis and can detect the presence of a lipid core. Further studies of plaque progression with NIVE are required to identify vulnerable plaques.

L’accident vasculaire cérébral (AVC) est une cause principale de décès et de morbidité dans le monde; une bonne partie des AVC est causée par la plaque d’athérosclérose carotidienne. La prévention de l’AVC chez les patients ayant une plaque carotidienne demeure controversée, vu les risques et bénéfices ambigus associés au traitement chirurgical ou médical. Plusieurs méthodes d’imagerie ont été développées afin d’étudier la plaque vulnérable (dont le risque est élevé), mais aucune n’est suffisamment validée ou accessible pour permettre une utilisation comme outil de dépistage. L’élastographie non-invasive vasculaire (NIVE) est une technique nouvelle qui cartographie les déformations (élasticité) de la plaque afin de détecter les plaque vulnérables; cette technique n’est pas encore validée cliniquement. Le but de ce projet est d’évaluer la capacité de NIVE de caractériser la composition de la plaque et sa vulnérabilité in vivo chez des patients ayant des plaques sévères carotidiennes, en utilisant comme étalon de référence, l’imagerie par résonance magnétique (IRM) à haute-résolution. Afin de poursuivre cette étude, une connaissance accrue de l’AVC, l’athérosclérose, la plaque vulnérable, ainsi que des techniques actuelles d’imagerie de la plaque carotidienne, est requise. Trente-et-un sujets ont été examinés par NIVE par ultrasonographie et IRM à haute-résolution. Sur 31 plaques, 9 étaient symptomatiques, 17 contenaient des lipides, et 7 étaient vulnérables selon l’IRM. Les déformations étaient significativement plus petites chez les plaques contenant des lipides, avec une sensibilité élevée et une spécificité modérée. Une association quadratique entre la déformation et la quantité de lipide a été trouvée. Les déformations ne pouvaient pas distinguer les plaques vulnérables ou symptomatiques. En conclusion, NIVE par ultrasonographie est faisable chez des patients ayant des sténoses carotidiennes significatives et peut détecter la présence d’un coeur lipidique. Des études supplémentaires de progression de la plaque avec NIVE sont requises afin d’identifier les plaques vulnérables. / Stroke is a leading cause of death and morbidity worldwide, and a significant proportion of strokes are caused by carotid atherosclerotic plaque rupture. Prevention of stroke in patients with carotid plaque poses a significant challenge to physicians, as risks and benefits of surgical or medical treatments remain equivocal. Many imaging techniques have been developed to identify and study vulnerable (high-risk) atherosclerotic plaques, but none is sufficiently validated or accessible for population screening. Non-invasive vascular elastography (NIVE) is a novel ultrasonic technique that maps carotid plaque strain (elasticity) characteristics to detect its vulnerability; it has not been clinically validated yet. The goal of this project is to evaluate the ability of ultrasound NIVE strain analysis to characterize carotid plaque composition and vulnerability in vivo in patients with significant plaque burden, as determined by the reference standard, high resolution MRI. To undertake this study, a thorough understanding of stroke, atherosclerosis, vulnerable plaque, and current non-invasive carotid plaque imaging techniques is required. Thirty-one subjects underwent NIVE and high-resolution MRI of internal carotid arteries. Of 31 plaques, 9 were symptomatic, 17 contained lipid and 7 were vulnerable on MRI. Strains were significantly lower in plaques containing a lipid core compared to those without lipid, with high sensitivity and moderate specificity. A quadratic fit was found between strain and lipid content. Strains did not discriminate symptomatic patients or vulnerable plaques. In conclusion, ultrasound NIVE is feasible in patients with significant carotid stenosis and can detect the presence of a lipid core. Further studies of plaque progression with NIVE are required to identify vulnerable plaques.