半影
医学
磁共振成像
神经影像学
随机对照试验
放射科
冲程(发动机)
灌注扫描
模式
急性中风
医学物理学
缺血
灌注
外科
内科学
组织纤溶酶原激活剂
社会学
工程类
精神科
机械工程
社会科学
作者
Phillip A. Bonney,Brian P. Walcott,Parampreet Singh,Phó̂ Nguyẽ̂n,Nerses Sanossian,William J. Mack
出处
期刊:Neurosurgery
[Oxford University Press]
日期:2019-06-14
卷期号:85 (suppl_1): S23-S30
被引量:16
标识
DOI:10.1093/neuros/nyz068
摘要
Abstract Advances in neuroimaging in the last 2 decades have revolutionized the management of acute ischemic stroke (AIS). Here we review the development of computed tomography (CT) and magnetic resonance imaging (MRI) modalities used to guide treatment of patients with AIS characterized by large vessel occlusion. In particular, we highlight recent randomized trials and their patient selection methodologies to detail the progression of these selection paradigms. With advanced imaging, distinction between at-risk penumbra and ischemic core in AIS may be performed using either CT or MRI. While limitations exist for methodologies to quantify core and penumbra, commercially available fully automated software packages provide useful information to guide treatment decisions. Randomized controlled trials implementing perfusion imaging to patient selection algorithms have demonstrated marked success in improving functional outcomes in patients with large vessel occlusions. As such, imaging has become a vital aspect of AIS treatment in selecting patients who may benefit from mechanical thrombectomy.
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