Zeenat Qureshi Stroke Research Center, University of Minnesota, Minneapolis, MN 55455, USA.
J Neuroimaging. 2013 Apr;23(2):163-4. doi: 10.1111/j.1552-6569.2011.00672.x. Epub 2012 Jan 10.
Noncontrast computed tomography (NCCT) has been considered the standard test for determining eligibility for thrombolysis from the beginning of the thrombolytic era. CT angiography (CTA) reveals the cranio-cervical vessel and the occlusion site. Furthermore, the source image (SI) of the CTA (CTA-SI) reflects cerebral blood volume and can detect the infarct core as hypoattenuated areas with higher sensitivity than ischemic changes on NCCT. However, it was recently reported that the CTA-SI using fast acquisition protocol significantly overestimated the infarct core mostly on the basis of the poor collaterals. On the other hand, CTA-SI using standardized protocol was reported to be good predictor for final infarct extension. Imaging used in the setting of acute stroke should accurately address the presence and size of an irreversible ischemic core. Further studies are required to confirm whether another measure or adjustment in CTA-SI values can be more reliable for evaluating the infarct core.
非对比计算机断层扫描（NCCT）自溶栓时代开始，就一直被认为是确定溶栓适应证的标准检查。CT 血管造影（CTA）可显示颅颈血管和闭塞部位。此外，CTA 的源图像（CTA-SI）反映了脑血容量，可以检测到梗死核心，其低衰减区域的检出率高于 NCCT 上的缺血性改变。然而，最近有报道称，快速采集方案的 CTA-SI 主要基于较差的侧支循环，会显著高估梗死核心。另一方面，有报道称，采用标准化方案的 CTA-SI 是最终梗死扩展的良好预测因子。用于急性脑卒中的影像学检查应准确评估不可逆性缺血核心的存在和大小。需要进一步的研究来证实是否可以通过另一种方法或 CTA-SI 值的调整，更可靠地评估梗死核心。
