Cereda Carlo W, Michel Patrik, Lovblad Karl-Olof, Carrera Emmanuel
Stroke center, Neurocentro della Svizzera Italiana, Ospedale Regionale di Lugano, 6900 Lugano.
Stroke center, Service de neurologie, CHUV, 1011 Lausanne.
Rev Med Suisse. 2017 Apr 26;13(560):890-893.
Multi-modal imaging in acute ischemic stroke includes structural imaging, perfusion imaging and angiographic assessment of brain arteries. Perfusion imaging discriminates brain tissue that is critically hypo-perfused but salvageable (ischemic penumbra) from irreversibly injured tissue (ischemic core). In acute reperfusion therapies (intravenous or endovascular), patients who have substantial penumbra and a small core (target mismatch pattern) are most likely to have a good clinical outcome. Patient selection based on multi-modal imaging is not proven mandatory for acute treatment in patients admitted within the established time-window. Multi-modal image-based patient selection may be promising tool to identify candidates for acute treatment beyond the established time-window.
急性缺血性卒中的多模态成像包括结构成像、灌注成像以及脑动脉血管造影评估。灌注成像可区分严重灌注不足但可挽救的脑组织（缺血半暗带）与不可逆损伤的组织（缺血核心）。在急性再灌注治疗（静脉或血管内治疗）中，具有大量半暗带和小核心（目标不匹配模式）的患者最有可能获得良好的临床结局。对于在既定时间窗内入院的患者，基于多模态成像进行患者选择在急性治疗中并非被证明是必需的。基于多模态图像的患者选择可能是一种有前景的工具，用于识别超出既定时间窗的急性治疗候选者。
