Melbourne Brain Centre, The Royal Melbourne Hospital, Parkville, Australia.
School of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville.
Curr Opin Neurol. 2022 Feb 1;35(1):24-30. doi: 10.1097/WCO.0000000000001020.
The purpose of this review is to summarize the role of the hub-and-spoke system in acute stroke care, highlight the role of advanced imaging and discuss emerging concepts and trials relevant to the hub-and-spoke model.
The advent of advanced stroke multimodal imaging has provided increased treatment options for patients, particularly in rural and regional areas. When used in the hub-and-spoke model, advanced imaging can help facilitate and triage transfers, appropriately select patients for acute therapy and treat patients who may otherwise be ineligible based on traditional time metrics.Recent, ongoing trials in this area may lead to an even greater range of patients being eligible for acute reperfusion therapy, including mild strokes and patients with large core infarct volumes.
Integration of advanced imaging into a hub-and-spoke system, when complemented with other systems including telemedicine, improves access to acute stroke care for patients in regional and rural areas.
本文旨在总结枢纽辐射系统在急性脑卒中治疗中的作用，强调高级影像学的作用，并讨论与枢纽辐射模型相关的新兴概念和试验。
高级脑卒中多模态影像学的出现为患者提供了更多的治疗选择，特别是在农村和偏远地区。当在枢纽辐射模型中使用时，高级影像学可以帮助促进和分诊转移，适当选择急性治疗的患者，并治疗那些可能由于传统时间指标而不符合条件的患者。该领域正在进行的最新试验可能会使更多的患者有资格接受急性再灌注治疗，包括轻度脑卒中患者和大核心梗死体积患者。
将高级影像学整合到枢纽辐射系统中，并辅以远程医疗等其他系统，可以改善农村和偏远地区患者获得急性脑卒中治疗的机会。
