Imaging of acute ischemic stroke

被引:32
作者
Rudkin S. [1 ]
Cerejo R. [2 ]
Tayal A. [2 ]
Goldberg M.F. [1 ]
机构
[1] Department of Radiology, Division of Neuroradiology, Allegheny Health Network, 320 E. North Ave, Pittsburgh, 15212, PA
[2] Department of Neurology, Comprehensive Stroke Center, Allegheny Health Network, 320 E. North Ave, Pittsburgh, 15212, PA
关键词
Acute ischemic stroke; ASPECTS; Core; Endovascular therapy; Multi-phase CTA; Penumbra; Perfusion;
D O I
10.1007/s10140-018-1623-x
中图分类号
学科分类号
摘要
For decades, imaging has been a critical component of the diagnostic evaluation and management of patients suspected of acute ischemic stroke (AIS). With each new advance in the treatment of AIS, the role of imaging has expanded in scope, sophistication, and importance in selecting patients who stand to benefit from potential therapies. Although the field of stroke imaging has been evolving for many years, there have been several major recent changes. Most notably, in late 2017, the window for treatment expanded to 24 h from onset of stroke symptoms in selected patients. Furthermore, for those patients in expanded time windows, guidelines issued in early 2018 now recommend the use of “advanced” imaging techniques in the acute setting, including CT perfusion and MRI, to guide therapeutic decision-making. With these and other changes, the emergency radiologist must be prepared to handle a growing volume and complexity of AIS imaging. This article reviews the various imaging modalities and techniques employed in the imaging of AIS patients, with an emphasis on recommendations from recent randomized controlled trials and national consensus guidelines. © 2018, American Society of Emergency Radiology.
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收藏
页码:659 / 672
页数:13
相关论文
共 81 条
[1]  
Talwalkar A., Uddin S., Trends in emergency department visits for ischemic stroke and transient ischemic attack: United States, 2001–2011, NCHS Data Brief, 194, (2015)
[2]  
Albers G.W., Marks M.P., Kemp S., Christensen S., Tsai J.P., Ortega-Gutierrez S., McTaggart R., Torbey M.T., Kim-Tenser M., Leslie-Mazwi T., Sarraj A., Kasner S.E., Ansari S.A., Yeatts S.D., Hamilton S., Mlynash M., Heit J.J., Zaharchuk G., Kim S., Carrozzella J., Palesch Y.Y., Demchuk A.M., Bammer R., Lavori P.W., Broderick J.P., Lansberg M.G., Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging, N Engl J Med, 378, pp. 708-718, (2018)
[3]  
Nogueira R.G., Jadhav A.P., Haussen D.C., Bonafe A., Budzik R.F., Bhuva P., Yavagal D.R., Ribo M., Cognard C., Hanel R.A., Sila C.A., Hassan A.E., Millan M., Levy E.I., Mitchell P., Chen M., English J.D., Shah Q.A., Silver F.L., Pereira V.M., Mehta B.P., Baxter B.W., Abraham M.G., Cardona P., Veznedaroglu E., Hellinger F.R., Feng L., Kirmani J.F., Lopes D.K., Jankowitz B.T., Frankel M.R., Costalat V., Vora N.A., Yoo A.J., Malik A.M., Furlan A.J., Rubiera M., Aghaebrahim A., Olivot J.M., Tekle W
[4]  
Powers, Et al., 2018 guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association, Stroke, 49, pp. e1-e55, (2018)
[5]  
Aghaebrahim A., Streib C., Rangaraju S., Kenmuir C.L., Giurgiutiu D.V., Horev A., Saeed Y., Callaway C.W., Guyette F.X., Martin-Gill C., Pacella C., Ducruet A.F., Jankowitz B.T., Jovin T.G., Jadhav A.P., Streamlining door to recanalization processes in endovascular stroke therapy, J Neurointerv Surg, 9, pp. 340-345, (2017)
[6]  
Messe S.R., Khatri P., Reeves M.J., Smith E.E., Saver J.L., Bhatt D.L., Grau-Sepulveda M.V., Cox M., Peterson E.D., Fonarow G.C., Schwamm L.H., Why are acute ischemic stroke patients not receiving IV tPA? Results from a national registry, Neurology, 87, pp. 1565-1574, (2016)
[7]  
Zaidi S.F., Shawver J., Espinosa Morales A., Salahuddin H., Tietjen G., Lindstrom D., Parquette B., Adams A., Korsnack A., Jumaa M.A., Stroke care: initial data from a county-based bypass protocol for patients with acute stroke, J Neurointerv Surg, 9, pp. 631-635, (2017)
[8]  
Rowley H.A., The four Ps of acute stroke imaging: parenchyma, pipes, perfusion, and penumbra, AJNR Am J Neuroradiol, 22, pp. 599-601, (2001)
[9]  
Wintermark M., Sanelli P.C., Albers G.W., Bello J., Derdeyn C., Hetts S.W., Johnson M.H., Kidwell C., Lev M.H., Liebeskind D.S., Rowley H., Schaefer P.W., Sunshine J.L., Zaharchuk G., Meltzer C.C., Imaging recommendations for acute stroke and transient ischemic attack patients: a joint statement by the American Society of Neuroradiology, the American College of Radiology and the Society of NeuroInterventional Surgery, Am J Neuroradiol, 34, pp. E117-E127, (2013)
[10]  
Morgan C.D., Stephens M., Zuckerman S.L., Waitara M.S., Morone P.J., Dewan M.C., Mocco J., Physiologic imaging in acute stroke: patient selection, Interv Neuroradiol, 21, pp. 499-510, (2015)