Department of Medicine, The University of Auckland, Auckland, New Zealand.
Int J Stroke. 2013 Jan;8(1):33-7. doi: 10.1111/j.1747-4949.2012.00970.x.
Neuroimaging plays an important role in acute stroke diagnosis and management, but it is not routinely used in rehabilitation settings. Incorporating imaging information in rehabilitation planning may eventually translate to better outcomes after stroke. Here we review the prediction of outcomes after stroke using magnetic resonance imaging. There are clear and specific relationships between the anatomy of the stroke lesion and impairments at the time of scanning, and at later time points in recovery. However, most studies demonstrate these relationships in groups of patients at the chronic stage. In order to be useful for rehabilitation, neuroimaging needs to provide prognostic information for individual patients at a much earlier stage. Recent studies have used diffusion tensor imaging and functional neuroimaging to address this, with promising results. Combining neuroimaging with clinical and neurophysiological assessments may also be useful. Future work in this area may support the tailoring of rehabilitation for individual patients based on their capacity for neural reorganization and recovery.
神经影像学在急性脑卒中的诊断和治疗中发挥着重要作用，但在康复环境中并未常规使用。将影像学信息纳入康复计划中，最终可能会改善脑卒中后的预后。本文综述了磁共振成像在脑卒中预后预测中的应用。脑卒中病灶的解剖结构与扫描时以及康复后期的功能障碍之间存在明确的、特定的关系。然而，大多数研究都是在慢性期的患者群体中证实了这些关系。为了对康复治疗有用，神经影像学需要在更早的阶段为个体患者提供预后信息。最近的研究使用弥散张量成像和功能神经影像学来解决这个问题，取得了有前景的结果。将神经影像学与临床和神经生理学评估相结合也可能具有一定价值。这一领域的未来研究可能支持根据患者的神经重组和恢复能力为其量身定制康复治疗。
