中国卒中杂志 ›› 2024, Vol. 19 ›› Issue (4): 459-467.DOI: 10.3969/j.issn.1673-5765.2024.04.009

• 综述 • 上一篇    下一篇

再灌注治疗的神经影像学评估

郝曼均1,王利圆1,熊云云1,2,3   

  1. 1 北京 100070 首都医科大学附属北京天坛医院神经病学中心
    2 国家神经系统疾病临床医学研究中心
    3 北京脑科学与类脑研究所
  • 收稿日期:2023-04-10 出版日期:2024-04-20 发布日期:2024-04-20
  • 通讯作者: 熊云云 xiongyunyun@bjtth.org
  • 基金资助:
    国家自然科学基金面上项目(82171272)
    北京市科技计划课题(Z211100003521019)

Neuroimaging Evaluation of Reperfusion Therapy

HAO Manjun1, WANG Liyuan1, XIONG Yunyun1,2,3   

  1. 1 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; 
    2 China National Clinical Research Center for Neurological Diseases, Beijing 100070, China; 
    3 Chinese Institute for Brain Research, Beijing 102206, China
  • Received:2023-04-10 Online:2024-04-20 Published:2024-04-20
  • Contact: XIONG Yunyun, E-mail: xiongyunyun@bjtth.org

摘要: 目前,以缺血半暗带为靶点的再灌注治疗是急性缺血性卒中的首选治疗措施。缺血半暗带的神经影像学评估方法不断更新,为组织窗指导再灌注治疗提供了更多依据。本文对缺血半暗带理论50年来的重要进展进行梳理,重点综述了现有的缺血半暗带神经影像学评估方法(如目前被广泛使用的缺血低灌注-梗死核心或临床症状-梗死核心错配、新兴的多时相CTA及ASL等),并对目前市场上5款主流影像自动后处理软件进行对比,以期为临床再灌注诊疗工作提供参考。

文章导读: 通过对缺血半暗带的神经影像学评估,比较不同的影像判读方法及自动后处理软件,以期为再灌注临床诊疗工作提供思路与借鉴。

关键词: 急性缺血性卒中; 再灌注治疗; 神经影像学; 缺血半暗带

Abstract: Currently, reperfusion therapy targeting the ischemic penumbra is the preferred treatment for acute ischemic stroke. The continuous advancements in neuroimaging techniques for the ischemic penumbra have provided more evidence for reperfusion therapy based on tissue window. This review summarized the significant progress of the ischemic penumbra over the past 50 years, focused on the current neuroimaging assessment methods of ischemic penumbra, including the widely used ischemic hypoperfusion-infarct core or clinical symptom-infarct core mismatch and emerging techniques such as multiphase CTA, ASL, etc. Additionally, this paper compared 5 mainstream automatic post-processing software of image in the market, aiming to provide reference for clinical reperfusion diagnosis and treatment.

Key words: Acute ischemic stroke; Reperfusion therapy; Neuroimaging; Ischemic penumbra

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