Functional cerebrovascular imaging in brain ischemia: permeability, reactivity, and functional MR imaging.
MR and CT have evolved and are both capable of providing important physiologic information for guiding acute stroke therapy. This information could help to alleviate the growing unease concerning the low numbers of patients who meet the nonindividualized epidemiologically-derived enrollment criteria for thrombolysis. Physiologic assessment, such as measurement of blood-brain barrier permeability, could lead to individualization of eligibility for thrombolysis with expanded patient enrollment. Cerebrovascular reactivity analysis ("brain stress test") could improve the management of patients who have carotid occlusive disease. Detection of impaired autoregulation would favor surgical or endovascular intervention as opposed to medical management in these patients. The application of physiologic imaging techniques will undoubtedly play a key role in the management of patients who have disorders of cerebral blood flow.
Mikulis
David J
DJ
Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, University of Toronto, ON, Canada. mikulis@uhnres.utoronto.ca
D001921:Brain / Q000098:blood supply* / Q000378:metabolism* / Q000473:pathology; D002545:Brain Ischemia / Q000175:diagnosis*; D001931:Brain Mapping / Q000379:methods; D002199:Capillary Permeability; D002560:Cerebrovascular Circulation; D003287:Contrast Media / Q000493:pharmacokinetics; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D014655:Vascular Resistance / Q000502:physiology
D003287:Contrast Media