Division of Neurology, University of Alberta, Edmonton, Alberta, Canada.
Can J Neurol Sci. 2010 Jan;37(1):4-16. doi: 10.1017/s0317167100009598.
Neuroimaging is essential to stroke diagnosis and management. To date, the non-contrast CT has served as our main diagnostic tool. Although brain parenchymal changes visible on CT do provide valuable prognostic information, they provide limited insight into the potential for tissue salvage in response to reperfusion therapy, such as thrombolysis. Newer advanced CT and MRI based imaging techniques have increased the detection sensitivity for hyperacute and chronic parenchymal changes, including ischemia and hemorrhage, permit visualization of blood vessels and cerebral blood flow. This review outlines the basic principles underlying acquisition and interpretation of these newer imaging modalities in the setting of acute stroke. The utility of advanced brain parenchymal and blood flow imaging in the context of acute stroke patient management is also discussed. Part II in this series is a discussion of how these techniques can be used to rationally select appropriate patients for thrombolysis based on pathophysiological data.
神经影像学对于中风的诊断和治疗至关重要。迄今为止，非对比 CT 一直是我们的主要诊断工具。虽然 CT 上可见的脑实质变化确实提供了有价值的预后信息，但它们对组织对再灌注治疗（如溶栓）的潜在挽救能力提供的了解有限。较新的基于 CT 和 MRI 的先进成像技术提高了对超急性和慢性实质变化（包括缺血和出血）的检测灵敏度，允许观察血管和脑血流。本综述概述了急性中风中获取和解释这些新成像方式的基本原理。还讨论了在急性中风患者管理中高级脑实质和血流成像的实用性。本系列的第二部分讨论了如何根据病理生理学数据，使用这些技术合理选择适合溶栓治疗的患者。
