Röther J
Department of Neurology, University Hospital Hamburg Eppendorf, Martinistr 52, 20246, Hamburg, Germany.
Thromb Res. 2001 Sep 30;103 Suppl 1:S125-33. doi: 10.1016/s0049-3848(01)00309-7.
Thrombolysis is an effective but potential deleterious therapy and should therefore be limited to patients with acute intracerebral vessel occlusion and salvageable tissue. MRI currently develops towards the new diagnostic standard for the selection of stroke patients eligible for acute thrombolytic treatment and acute stroke studies. Diffusion- and perfusion-weighed MRI provides diagnostic information not available from the neurological assessments or from CCT and conventional spin-echo MRI. As high-speed DWI and PWI protocols become standardized, a 15-minute integrated stroke protocol of employing echo-planar imaging (EPI) can be outinely performed in the setting of acute clinical stroke. The combination of these MR techniques is suitable to define tissue at risk of infarction that is potentially salvageable brain tissue (an estimate of the ischemic penumbra) and may respond to early recanalization even beyond 3 hours after stroke onset. The extension of the therapeutic window for thrombolytic therapy towards 6 hours in a subpopulation of acute stroke patients might open the way for the successful reperfusion therapy in more stroke patients.
溶栓是一种有效但有潜在危害的治疗方法，因此应仅限于患有急性脑血管闭塞且有可挽救组织的患者。目前，MRI正朝着新的诊断标准发展，用于选择适合急性溶栓治疗和急性中风研究的中风患者。扩散加权和灌注加权MRI提供了神经学评估、CT和传统自旋回波MRI无法提供的诊断信息。随着高速DWI和PWI协议的标准化，采用回波平面成像（EPI）的15分钟综合中风协议可以在急性临床中风的情况下常规执行。这些MR技术的组合适合于定义有梗死风险的组织，即潜在可挽救的脑组织（缺血半暗带的估计），并且即使在中风发作后3小时以上也可能对早期再通有反应。在一部分急性中风患者中，将溶栓治疗的治疗窗口延长至6小时可能为更多中风患者成功进行再灌注治疗开辟道路。
