Division of Neurology, University of Alberta, Edmonton, Alberta, Canada.
Can J Neurol Sci. 2010 Jan;37(1):17-27. doi: 10.1017/s0317167100009604.
In acute ischemic stroke, the volume of threatened but potentially salvageable tissue, i.e. the ischemic penumbra, is critical to the success of all acute therapeutic interventions, most notably thrombolysis. Despite the availability of both CT and MRI based techniques to detect and assess the penumbra, advanced imaging of this type remains under-utilized. Although the optimal selection criteria are still being refined and technical improvements are ongoing, rapid imaging of the penumbra appears to be the most promising approach to expanding the acute thrombolysis population, as well as tailoring treatment based on specific pathophysiological findings. This second article in a two-part series reviews current evidence for penumbral-based treatment selection and discusses the barriers to implementation of these advanced imaging techniques in acute stroke management protocols.
在急性缺血性脑卒中，受威胁但具有潜在可挽救组织的体积，即缺血半暗带，对于所有急性治疗干预的成功至关重要，尤其是溶栓治疗。尽管有 CT 和 MRI 等基于影像学的技术可用于检测和评估缺血半暗带，但这种先进的影像学技术仍未得到充分利用。尽管最佳选择标准仍在不断完善，技术也在不断改进，但快速成像缺血半暗带似乎是扩大急性溶栓治疗人群的最有前途的方法，同时也可以根据特定的病理生理发现来调整治疗。这是两篇系列文章中的第二篇，回顾了基于缺血半暗带来选择治疗的现有证据，并讨论了在急性脑卒中管理方案中实施这些先进影像学技术的障碍。
