Learning objectives
The purpose of the study was:
-to describe different imaging techniques for assessing the parenchymal and vascular status in acute ischemic stroke (AIS),
-to evaluate which method can provide a fast and precise diagnosis,
improve the outcome,
and provide timely intravenous thrombolysis and mechanical thrombectomy,
-to evaluate new advanced techniques such as non-contrast arterial spin labeling (ASL) perfusion and protocols in diagnosis of stroke.
Background
Since stroke is the third leading cause of death and the most common cause of permanent disability among the world population,
imaging is essential for the assessment of patients suspected of AIS.
Nowadays,
there are various imaging techniques for assessing vascular and brain status in AIS.
CT is most commonly used as a standard diagnostic method worldwide.
However,
the invention of new MRI techniques is likely to improve imaging and diagnostic accuracy.
The rapid advancement in neuroimaging,
such as the innovations of DWI,
PWI,
SWAN,...
Findings and procedure details
Commonly used as a standard diagnostic method in acute stroke is multimodal CT,
combines noncontrast (NCCT),perfusion computed tomography (PCT),
and CT angiography (CTA).
This approach application has demonstrated the ability for detection of acute infarction,
allowing assessment of the site of vascular occlusion,
the infarct core,
salvageable brain tissue and estimate the degree of collateral circulation.The use of PCT increased the sensitivity of confirming ischemic lesions by depicting an area of perfusion disturbance corresponding with the clinical symptoms.PCT may enable the distinction between penumbra and...
Conclusion
Nowadays,
there are various imaging techniques for assessing vascular and brain status in acute stroke. The most useful method should provide a fast diagnosis,
thus enabling improved outcomes and providing a timely mechanical thrombectomy.In comparison to CT,
MRI with advanced sequences such as ASL is considered to be more accurate,
more reliable and therefore superior for the ischemic stroke diagnosis.
References
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CT protocol for acute stroke: tips and tricks for general radiologists.
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One-stop-shop stroke imaging with functional CT.
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Mielke O.
Early signs of brain infarction at CT: observer reliability and outcome after thrombolytic...