Desal H A, Auffray-Calvier E, Guillon B, Toulgoat F, Madoz A, De Kersaint-Gilly A, Pasco-Papon A
Service de Neuroradiologie Diagnostique et Interventionnelle, Hôpital G & R Laënnec, CHU de Nantes, France.
J Neuroradiol. 2004 Sep;31(4):327-33. doi: 10.1016/s0150-9861(04)97011-3.
Over the last 25 years, advances in neuroimaging have significantly changed the evaluation and management of acute stroke syndromes. In the seventies, computed tomography (CT) could differentiate between ischemic and hemorrhagic stroke. Magnetic resonance imaging (MRI) is nowadays the imaging modality of choice in the initial assessment of acute stroke. MRI images can better discriminate acute, subacute and chronic infarcts, differentiate venous from arterial infarcts, detect arterial dissection, stenosis or occlusion. Diffusion-weighted images are highly sensitive and specific to acute infarction and the combination with perfusion technique is suitable to define potentially reversible ischemia (area of cerebral "mismatch" which is thought to represent the so-called ischemic penumbra). This penumbra is a potential therapeutic target of valuable interest for the treating physician.
在过去25年中，神经影像学的进展显著改变了急性卒中综合征的评估和管理。在20世纪70年代，计算机断层扫描（CT）能够区分缺血性卒中和出血性卒中。如今，磁共振成像（MRI）是急性卒中初始评估中首选的成像方式。MRI图像能够更好地鉴别急性、亚急性和慢性梗死，区分静脉性梗死和动脉性梗死，检测动脉夹层、狭窄或闭塞。弥散加权成像对急性梗死具有高度敏感性和特异性，与灌注技术相结合适用于定义潜在可逆性缺血（脑“不匹配”区域，被认为代表所谓的缺血半暗带）。这个半暗带是治疗医生极具价值的潜在治疗靶点。
