Weinstein Joseph D, Hamam Omar, Urrutia Victor C, Lu Hanzhang, Luna Licia P, Tekes-Brady Aylin, Bahouth Mona, Yedavalli Vivek
Department of Radiology and Radiological Sciences, Division of Neuroradiology, Johns Hopkins School of Medicine, Baltimore, MD, United States.
Department of Neurology, Comprehensive Stroke Center, Johns Hopkins School of Medicine, Baltimore, MD, United States.
Front Neurol. 2022 Mar 3;13:831218. doi: 10.3389/fneur.2022.831218. eCollection 2022.
Differentiating stroke from stroke mimics is a diagnostic challenge in every day practice. Posterior Reversible Encephalopathy Syndrome (PRES) is an important stroke mimic with nonspecific symptomatology, making prompt and accurate diagnosis challenging. Baseline neuroimaging plays a pivotal role in detection and differentiation of stroke from many common mimics and is thus critical in guiding appropriate management. In particular, MR perfusion (MRP) imaging modalities provide added value through detection and quantification of multiple physiological parameters. Arterial Spin Labeling (ASL) is a non-contrast, noninvasive MRP technique increasingly used in clinical practice; however, there is limited description of ASL in PRES in the existing literature. In this single center retrospective pilot study, we investigate the added value of ASL in detecting PRES in the largest series to date. We hope this study can serve as the basis for larger scale investigations exploring the utility of ASL in detecting stroke mimics such as PRES for accurate and efficient management of such patients.
在日常临床实践中，鉴别中风与疑似中风的病症是一项诊断挑战。后部可逆性脑病综合征（PRES）是一种重要的疑似中风病症，其症状不具特异性，因此快速准确诊断颇具挑战。基线神经影像学在检测中风并将其与许多常见疑似病症相鉴别方面起着关键作用，对指导恰当治疗至关重要。尤其是，磁共振灌注（MRP）成像方式通过检测和量化多个生理参数提供了附加价值。动脉自旋标记（ASL）是一种非对比、非侵入性的MRP技术，在临床实践中使用越来越广泛；然而，现有文献中关于ASL在PRES中的描述有限。在这项单中心回顾性初步研究中，我们在迄今最大的病例系列中探究了ASL在检测PRES方面的附加价值。我们希望这项研究能够作为更大规模调查的基础，探索ASL在检测诸如PRES等疑似中风病症方面的效用，以便对此类患者进行准确有效的管理。
