Clinical MRI of acute ischemic stroke.
Clinical MRI of acute ischemic stroke.
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DOI：
10.1002/jmri.23595
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发表时间：
2012-08
影响因子：
4.4
通讯作者：
Gonzalez, R. Gilberto
中科院分区：
文献类型：
--
作者：
Gonzalez, R. Gilberto
影像学为缺血性卒中患者提供的最重要的服务是快速识别那些最有可能从立即治疗中获益的患者。该组包括因大动脉闭塞而出现严重神经系统症状的患者，以及需要使用静脉溶栓或动脉内介入进行再通以清除闭塞的患者。这些患者的预后取决于症状的严重程度、闭塞的动脉、出现时梗死的大小和治疗效果。MRI通过MR血管造影和弥散MRI提供关键的生理信息，已被证明在识别需要立即治疗的患者方面具有很高的临床价值。灌注MRI提供了有关缺血半暗带的信息，但其临床价值尚未得到证实。在目前的临床实践中，在治疗决策中，自卒中发作以来的时间在MRI提供的生理信息中占主导地位。只有当临床试验证明MRI所揭示的卒中生理学在促进良好临床结局方面上级卒中发作时间时，这种情况才会改变。
The most important service that imaging provides to patients with ischemic stroke is to rapidly identify those patients who are most likely to benefit from immediate treatment. This group includes patients who have severe neurological symptoms due to an occlusion of a major artery, and who are candidates for recanalization using intravenous thrombolysis or intra-arterial intervention to remove the occlusion. Outcomes for these patients are determined by symptom severity, the artery that is occluded, the size of the infarct at the time of presentation, and the effect of treatment. MRI provides key physiological information through MR angiography and diffusion MRI that has been proven to be of high clinical value in identify patients who are in need of immediate treatment. Perfusion MRI provides information about the ischemic penumbra, but its clinical value is unproven. In current clinical practice the time since stroke onset is dominant over physiologic information provided by MRI in treatment decisions. This will change only when clinical trials prove that stroke physiology as revealed by MRI is superior to time from stroke onset in promoting good clinical outcomes.
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