Imaging-based treatment selection for intravenous and intra-arterial stroke therapies: a comprehensive review.
Imaging-based treatment selection for intravenous and intra-arterial stroke therapies: a comprehensive review.
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DOI：
10.1586/erc.11.56
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发表时间：
2011-07
影响因子：
2
通讯作者：
Gonzalez RG
中科院分区：
文献类型：
--
作者：
Yoo AJ;Pulli B;Gonzalez RG
再灌注治疗是唯一被批准的治疗急性缺血性中风的方法。目前选择患者的方法主要基于中风症状出现的时间。然而，该算法极大地限制了符合条件的患者群体，并且忽略了侧支循环的巨大变化，而侧支循环最终决定了个体患者的治疗时间窗口。单独的时间不太可能仍然是主要参数。选择患者的替代方法涉及先进的神经影像学方法，包括 MRI 扩散加权成像、磁共振和计算机断层扫描灌注成像以及无创血管造影，这些方法可提供有关脑实质和神经脉管系统状态的潜在有价值的信息。这些技术现已被广泛使用，并且有新的证据表明特定的成像数据如何改善临床结果。本文将回顾调查影像学在静脉内和动脉内治疗患者选择中的作用的主要研究。
Reperfusion therapy is the only approved treatment for acute ischemic stroke. The current approach to patient selection is primarily based on the time from stroke symptom onset. However, this algorithm sharply restricts the eligible patient population, and neglects large variations in collateral circulation that ultimately determine the therapeutic time window in individual patients. Time alone is unlikely to remain the dominant parameter. Alternative approaches to patient selection involve advanced neuroimaging methods including MRI diffusion-weighted imaging, magnetic resonance and computed tomography perfusion imaging and noninvasive angiography that provide potentially valuable information regarding the state of the brain parenchyma and the neurovasculature. These techniques have now been used extensively, and there is emerging evidence on how specific imaging data may result in improved clinical outcomes. This article will review the major studies that have investigated the role of imaging in patient selection for both intravenous and intra-arterial therapies.