[Perfusion imaging of acute ischemic stroke]
Carlo W Cereda1,2, Patrik Michel2, Karl-Olof Lovblad3
1Stroke center, Neurocentro della Svizzera Italiana, Ospedale Regionale di Lugano, 6900 Lugano.
Revue Medicale Suisse
|July 21, 2017
Summary
Multi-modal imaging helps identify salvageable brain tissue in acute ischemic stroke. This approach, particularly the target mismatch pattern, guides reperfusion therapy decisions for better patient outcomes.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Acute ischemic stroke requires rapid assessment and treatment.
- Multi-modal imaging provides comprehensive data on brain tissue status.
Purpose of the Study:
- To evaluate the role of multi-modal imaging in acute ischemic stroke patient selection.
- To assess the significance of the target mismatch pattern in reperfusion therapy.
Main Methods:
- Utilizing structural imaging, perfusion imaging, and angiographic assessment.
- Differentiating ischemic penumbra (salvageable tissue) from ischemic core (irreversible injury).
Main Results:
- Perfusion imaging is key to identifying the ischemic penumbra and core.
- A substantial penumbra with a small core (target mismatch) predicts good outcomes with reperfusion therapy.
Conclusions:
- Multi-modal imaging is not mandatory for acute stroke treatment within standard time windows.
- Image-based selection may identify candidates for treatment beyond established time limits.
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