Hillis Argye E
Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, Phipps 126, 600 North Wolfe Street, Baltimore, MD 21287, USA.
Ann N Y Acad Sci. 2005 Dec;1064:149-61. doi: 10.1196/annals.1340.027.
Diffusion and perfusion MRI have contributed to stroke management by identifying patients with tissue "at risk" for further damage in acute stroke. However, the potential usefulness of these imaging modalities, along with diffusion tensor imaging, can be expanded by using these imaging techniques with concurrent assessment of language and other cognitive skills to identify the specific cognitive deficits that are associated with diffusion and perfusion abnormalities in particular brain regions. This paper illustrates how this combined behavioral and imaging methodology can yield information that is useful for predicting specific positive effects of intervention to restore blood flow in hypoperfused regions of brain identified with perfusion MRI, and for predicting negative effects of resection of particular brain regions or fiber bundles. Such data allow decisions about neurological and neurosurgical interventions to be based on specific risks and benefits in terms of functional consequences.
扩散加权磁共振成像（Diffusion MRI）和灌注加权磁共振成像（perfusion MRI）通过识别急性卒中患者中存在进一步组织损伤“风险”的组织，为卒中治疗做出了贡献。然而，通过将这些成像技术与语言和其他认知技能的同步评估相结合，以识别与特定脑区扩散和灌注异常相关的特定认知缺陷，这些成像方式以及扩散张量成像（diffusion tensor imaging）的潜在用途可以得到扩展。本文阐述了这种行为与成像相结合的方法如何能够产生有用信息，这些信息有助于预测对灌注MRI所确定的脑灌注不足区域进行血流恢复干预的特定积极效果，以及预测特定脑区或纤维束切除的消极效果。这些数据能够使关于神经和神经外科干预的决策基于功能后果方面的特定风险和益处。
