Minematsu K, Hasegawa Y, Yamaguchi T
Rinsho Shinkeigaku. 1995 Dec;35(12):1575-7.
There are several new magnetic resonance (MR) technologies, which will provide data about the pathogenesis, circulatory state and cellular effects of ischemic stroke. Among them, diffusion MRI is the most promising one. This technology clearly reveals, within minutes of stroke onset, ischemic lesions which ultimately progress to infarct. The early ischemic lesions demonstrated by diffusion MRI represent regions with slower water diffusions perhaps due to intracellular water accumulation or shrinkage of the extracellular spaces resulting from ionic pump failure, spreading depression, or other mechanisms. The diffusion MRI can show not only irreversible but also reversible ischemic lesions, and therefore has a potential to discriminate salvageable tissues from irreversibly damaged tissues before a therapeutic intervention with thrombolytic and/or cytoprotective agents. The diffusion MRI can highlight only a fresh lesion, because water diffusion is decreased during several days after stroke onset. Diffusion MRI is extremely prone to motion artifacts, a major concern against clinical application. This problem can be solved by combination with an ultrafast technique, echo planar (EP) imaging. The EP diffusion MRI will become a rapid, reliable, objective and essential emergency diagnostic test in a clinical setting that will guide the development and application of acute therapeutic intervention.
有几种新的磁共振（MR）技术，它们将提供有关缺血性中风的发病机制、循环状态和细胞效应的数据。其中，扩散加权磁共振成像最为有前景。这项技术能在中风发作几分钟内清晰显示最终发展为梗死的缺血性病变。扩散加权磁共振成像显示的早期缺血性病变代表水扩散较慢的区域，这可能是由于细胞内积水或离子泵衰竭、扩散性抑制或其他机制导致的细胞外间隙缩小所致。扩散加权磁共振成像不仅能显示不可逆的缺血性病变，还能显示可逆性缺血性病变，因此在使用溶栓和/或细胞保护剂进行治疗干预之前，有潜力区分可挽救组织和不可逆损伤组织。扩散加权磁共振成像只能突出显示新鲜病变，因为中风发作后的几天内水扩散会降低。扩散加权磁共振成像极易出现运动伪影，这是临床应用中的一个主要问题。这个问题可以通过与超快速技术——回波平面（EP）成像相结合来解决。回波平面扩散加权磁共振成像将成为临床环境中一种快速、可靠、客观且必不可少的紧急诊断测试，它将指导急性治疗干预的开发和应用。
