Gomori John M, Cohen José E
Division of Endovascular Neurosurgery and Interventional Neuroradiology, Hadassah Ein Kerem University Hospital, Jerusalem, Israel.
Neurol Res. 2005;27 Suppl 1:S50-2. doi: 10.1179/016164105X35558.
Rapid imaging of cerebral perfusion in acute stroke is needed for timely triage of patients for thrombolytic therapy. Accurate quantitative perfusion imaging is required for proper assessment of penumbral brain parenchyma truly at risk for extension of infarction from the irreversible core infarction. CT and MRI techniques offer rapidity and availability for acute stroke imaging, including that of cerebral perfusion. CT perfusion techniques are readily available, but suffer from limited brain coverage of present multislice scanners. MRI offers whole brain coverage, but suffers from less availability and higher cost than CT. Presently, development is directed towards increasing the quantitative accuracy of cerebral perfusion imaging and validation of surrogate parameters, such as time to peak (TTP). In the future, the need for rapid and frequent assessment of cerebral perfusion and its metabolic correlates, with minimal or no radiation, will probably be met by MRI.
急性卒中患者进行溶栓治疗时需要对脑灌注进行快速成像，以便及时进行分诊。为了准确评估真正处于梗死扩展风险中的半暗带脑实质，需要精确的定量灌注成像，这种梗死扩展是从不可逆的核心梗死发展而来的。CT和MRI技术为急性卒中成像（包括脑灌注成像）提供了快速性和可用性。CT灌注技术易于获得，但目前的多层螺旋CT扫描仪对脑部的覆盖范围有限。MRI能够覆盖全脑，但可用性不如CT，且成本更高。目前，研究方向是提高脑灌注成像的定量准确性以及验证替代参数，如达峰时间（TTP）。未来，对脑灌注及其代谢相关性进行快速且频繁的评估，同时辐射最小或无辐射的需求，可能会通过MRI来满足。
