Magnetic resonance imaging: implication in acute ischemic stroke management.
Multimodality magnetic resonance imaging (MRI) techniques, including diffusion-weighted imaging (DWI), perfusion-weighted imaging (PWI), fluid-attenuated inversion recovery (FLAIR), T2 susceptibility imaging, and magnetic resonance angiography (MRA), quickly provide accurate information about ischemic penumbra (DWI/PWI mismatch), tissue perfusion, and vascular localization in acute stroke setting. These techniques help physicians to select the proper candidates for thrombolysis and/or neuroprotective treatment to salvage tissue at risk (mismatch) and monitor acute stroke patients after treatment. Recent and ongoing trials demonstrate the benefit of treating acute stroke patients depending on tissue at risk of infarction rather than timing of onset. These techniques will extend timing to salvage ischemic brain tissue beyond the 3-hour window. MRI is a powerful tool for managing acute stroke patients and helps elucidate the pathophysiology of cerebral ischemia in a given patient.
Department of Neurology - VBK 915, Massachusetts General Hospital, Boston, MA 02114-2622, USA.
Oraporn
O
Sitburana
Walter J
WJ
Koroshetz
D000208:Acute Disease; D002545:Brain Ischemia / Q000473:pathology*; D002560:Cerebrovascular Circulation; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging; D019786:Gadolinium DTPA; D006801:Humans; D020300:Intracranial Hemorrhages / Q000175:diagnosis; D049268:Positron-Emission Tomography; D020521:Stroke / Q000473:pathology*; D014654:Vascular Patency
D003287:Contrast Media; D019786:Gadolinium DTPA