Mikulis David J
Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, University of Toronto, ON, Canada.
Neuroimaging Clin N Am. 2005 Aug;15(3):667-80, xii. doi: 10.1016/j.nic.2005.08.001.
MR and CT have evolved and are both capable of providing important physiologic information for guiding acute stroke therapy. This information could help to alleviate the growing unease concerning the low numbers of patients who meet the nonindividualized epidemiologically-derived enrollment criteria for thrombolysis. Physiologic assessment, such as measurement of blood-brain barrier permeability, could lead to individualization of eligibility for thrombolysis with expanded patient enrollment. Cerebrovascular reactivity analysis ("brain stress test") could improve the management of patients who have carotid occlusive disease. Detection of impaired autoregulation would favor surgical or endovascular intervention as opposed to medical management in these patients. The application of physiologic imaging techniques will undoubtedly play a key role in the management of patients who have disorders of cerebral blood flow.
磁共振成像（MR）和计算机断层扫描（CT）已经得到了发展，二者都能够为指导急性中风治疗提供重要的生理信息。这些信息有助于缓解人们日益增长的不安情绪，即符合基于非个体化流行病学得出的溶栓入组标准的患者数量较少。生理评估，如血脑屏障通透性的测量，可能会通过扩大患者入组来实现溶栓资格的个体化。脑血管反应性分析（“脑应激试验”）可以改善患有颈动脉闭塞性疾病患者的管理。在这些患者中，检测到自动调节受损将更倾向于手术或血管内介入治疗，而非药物治疗。生理成像技术的应用无疑将在患有脑血流紊乱患者的管理中发挥关键作用。
