急性卒中成像研究路线图III：急性卒中再灌注临床试验中的成像选择与结果：共识建议及进一步研究重点
Acute Stroke Imaging Research Roadmap III Imaging Selection and Outcomes in Acute Stroke Reperfusion Clinical Trials: Consensus Recommendations and Further Research Priorities.
作者信息
Warach Steven J, Luby Marie, Albers Gregory W, Bammer Roland, Bivard Andrew, Campbell Bruce C V, Derdeyn Colin, Heit Jeremy J, Khatri Pooja, Lansberg Maarten G, Liebeskind David S, Majoie Charles B L M, Marks Michael P, Menon Bijoy K, Muir Keith W, Parsons Mark W, Vagal Achala, Yoo Albert J, Alexandrov Andrei V, Baron Jean-Claude, Fiorella David J, Furlan Anthony J, Puig Josep, Schellinger Peter D, Wintermark Max
机构信息
From the Department of Neurology, Dell Medical School, University of Texas at Austin (S.J.W.); Stroke Branch, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD (M.L.); Department of Neurology (G.W.A., M.G.L.), Department of Radiology (R.B.), Neuroradiology Section, Department of Radiology (J.J.H., M.P.M., M.W.), Stanford University School of Medicine, CA; Department of Neurology, John Hunter Hospital, Hunter Medical Research Institute, University of Newcastle, Callaghan, New South Wales, Australia (A.B., M.W.P.); Departments of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia (B.C.V.C.); Department of Radiology, University of Iowa Hospitals and Clinics Iowa City (C.D.); Departments of Neurology (P.K.) and Neuroadiology (A.V.), University of Cincinnati, OH; Neurovascular Imaging Research Core and UCLA Stroke Center, Department of Neurology, University of California, Los Angeles (D.S.L.); Department of Radiology, AMC, Amsterdam, The Netherlands (C.B.L.M.M.); Calgary Stroke Program, Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (B.K.M.); Institute of Neurosciences and Psychology, University of Glasgow, Southern General Hospital, Glasgow, Scotland, United Kingdom (K.W.M.); Texas Stroke Institute, Plano (A.J.Y.); Department of Neurology, The University of Tennessee Health Science Center, Memphis (A.V.A.); INSERM U894, Centre Hospitalier Sainte-Anne, Sorbonne Paris Cité, Paris, France (J.-C.B.); Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom (J.-C.B.); Department of Neurosurgery, State University of New York at Stony Brook (D.J.F.); Department of Neurology, University Hospitals Case Medical Center and Case Western Reserve University, Cleveland, OH (A.J.F.); Department of Radiology, Hospital Josep Tru
出版信息
Stroke. 2016 May;47(5):1389-98. doi: 10.1161/STROKEAHA.115.012364. Epub 2016 Apr 12.
BACKGROUND AND PURPOSE
The Stroke Imaging Research (STIR) group, the Imaging Working Group of StrokeNet, the American Society of Neuroradiology, and the Foundation of the American Society of Neuroradiology sponsored an imaging session and workshop during the Stroke Treatment Academy Industry Roundtable (STAIR) IX on October 5 to 6, 2015 in Washington, DC. The purpose of this roadmap was to focus on the role of imaging in future research and clinical trials.
METHODS
This forum brought together stroke neurologists, neuroradiologists, neuroimaging research scientists, members of the National Institute of Neurological Disorders and Stroke (NINDS), industry representatives, and members of the US Food and Drug Administration to discuss STIR priorities in the light of an unprecedented series of positive acute stroke endovascular therapy clinical trials.
RESULTS
The imaging session summarized and compared the imaging components of the recent positive endovascular trials and proposed opportunities for pooled analyses. The imaging workshop developed consensus recommendations for optimal imaging methods for the acquisition and analysis of core, mismatch, and collaterals across multiple modalities, and also a standardized approach for measuring the final infarct volume in prospective clinical trials.
CONCLUSIONS
Recent positive acute stroke endovascular clinical trials have demonstrated the added value of neurovascular imaging. The optimal imaging profile for endovascular treatment includes large vessel occlusion, smaller core, good collaterals, and large penumbra. However, equivalent definitions for the imaging profile parameters across modalities are needed, and a standardization effort is warranted, potentially leveraging the pooled data resulting from the recent positive endovascular trials.
背景与目的
卒中影像研究（STIR）小组、卒中网络影像工作组、美国神经放射学会以及美国神经放射学会基金会于2015年10月5日至6日在华盛顿特区举办的卒中治疗学会行业圆桌会议（STAIR）IX期间，共同主办了一次影像会议及研讨会。本路线图的目的是聚焦影像在未来研究和临床试验中的作用。
方法
该论坛汇聚了卒中神经科医生、神经放射科医生、神经影像研究科学家、美国国立神经疾病与卒中研究所（NINDS）成员、行业代表以及美国食品药品监督管理局成员，以根据一系列前所未有的急性卒中血管内治疗阳性临床试验，讨论STIR的优先事项。
结果
影像会议总结并比较了近期血管内治疗阳性试验的影像组成部分，并提出了汇总分析的机会。影像研讨会就跨多种模式采集和分析核心、不匹配及侧支循环的最佳影像方法，以及在前瞻性临床试验中测量最终梗死体积的标准化方法，制定了共识性建议。
结论
近期急性卒中血管内治疗阳性临床试验已证明神经血管影像的附加价值。血管内治疗的最佳影像特征包括大血管闭塞、较小核心、良好侧支循环及大的半暗带。然而，跨模式的影像特征参数需要等效定义，且有必要进行标准化工作，这可能借助近期血管内治疗阳性试验产生的汇总数据。
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