Pulli Benjamin, Heit Jeremy J, Wintermark Max
Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford Healthcare, 300 Pasteur Drive, Stanford, CA 94305, USA.
Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford Healthcare, 300 Pasteur Drive, Stanford, CA 94305, USA.
Neuroimaging Clin N Am. 2021 May;31(2):235-250. doi: 10.1016/j.nic.2020.12.002. Epub 2021 Mar 23.
Computed tomography remains the most widely used imaging modality for evaluating patients with acute ischemic stroke. Landmark trials have used computed tomography imaging to select patients for intravenous thrombolysis and endovascular treatment. This review summarizes the most important acute ischemic stroke trials, provides an outlook of ongoing studies, and proposes possible image algorithms for patient selection. Although evaluation with anatomic computed tomography imaging techniques is sufficient in early window patients, more advanced imaging techniques should be used beyond 6 hours from symptoms onset to quantify the ischemic core and evaluate for the salvageable penumbra.
计算机断层扫描仍然是评估急性缺血性中风患者最广泛使用的成像方式。具有里程碑意义的试验已使用计算机断层扫描成像来选择适合静脉溶栓和血管内治疗的患者。本综述总结了最重要的急性缺血性中风试验,展望了正在进行的研究,并提出了可能用于患者选择的图像算法。虽然对于早期窗口期的患者,解剖学计算机断层扫描成像技术的评估就足够了,但对于症状发作6小时后的患者,应使用更先进的成像技术来量化缺血核心并评估可挽救的半暗带。