From the Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemungu, 120-752, Seoul, Republic of Korea.
Radiology. 2017 Apr;283(1):14-28. doi: 10.1148/radiol.2016152043.
While the etiology of ischemic stroke is heterogeneous, approximately 20%-40% of all stroke cases result from cardiac or aortic origin. Transesophageal echocardiography (TEE) has become the reference standard modality for the detection of potential sources of cerebral embolism. Because of the advances in computed tomographic (CT) technology, cardiac CT can be used in the evaluation of potential cardioembolic sources. During the past decade, cardiac CT has been tested and compared with TEE for the diagnosis of cardioembolic sources. Many studies showed that cardiac CT is a very useful and powerful modality for the detection of cardioembolic sources, as well as for risk assessment in patients with stroke. Cardiac CT is a reliable alternative imaging modality to TEE for the evaluation of cardioembolic sources in patients with ischemic stroke, avoiding the discomfort and risks associated with TEE. In addition, cardiac CT can be used to simultaneously diagnose coronary artery disease in stroke patients. However, based on current guidelines, cardiac CT is currently not recommended for use in the initial evaluation of intracardiac structures or risk assessment in stroke patients. The aim of this review is to discuss the potential clinical applications of cardiac CT in an ischemic stroke population, focusing on the diagnosis of cardioembolic sources and cardiovascular risk assessment using cardiac CT. RSNA, 2017.
虽然缺血性脑卒中的病因具有异质性，但约 20%-40%的脑卒中病例由心源性或主动脉源性引起。经食管超声心动图（TEE）已成为检测潜在脑栓塞源的标准参考模式。由于计算机断层扫描（CT）技术的进步，心脏 CT 可用于评估潜在的心源性栓塞源。在过去十年中，心脏 CT 已被测试并与 TEE 进行比较，以诊断心源性栓塞源。许多研究表明，心脏 CT 是一种非常有用和强大的方法，可用于检测心源性栓塞源，以及对脑卒中患者进行风险评估。心脏 CT 是评估缺血性脑卒中患者心源性栓塞源的一种可靠的替代影像学方法，可避免 TEE 相关的不适和风险。此外，心脏 CT 可用于同时诊断脑卒中患者的冠状动脉疾病。然而，根据目前的指南，心脏 CT 目前不推荐用于初始评估心内结构或脑卒中患者的风险评估。本文旨在讨论心脏 CT 在缺血性脑卒中人群中的潜在临床应用，重点介绍心脏 CT 在诊断心源性栓塞源和心血管风险评估方面的应用。RSNA，2017 年。
