지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
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초록· 키워드
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Although intravenous administration of tissue plasminogen activator is the only proven treatment after acute ischemic stroke, there is always a concern of hemorrhagic risk after thrombolysis. Therefore, selection of patients with potential benefits in overcoming potential harms of thrombolysis is of great importance. Despite the practical issues in using magnetic resonance imaging (MRI) for acute stroke treatment, multimodal MRI can provide useful information for accurate diagnosis of stroke, evaluation of the risks and benefits of thrombolysis, and prediction of outcomes. For example, the high sensitivity and specificity of diffusion-weighted image (DWI) can help distinguish acute ischemic stroke from stroke-mimics. Additionally, the lesion mismatch between perfusion-weighted image (PWI) and DWI is thought to represent potential salvageable tissue by reperfusion therapy. However, the optimal threshold to discriminate between benign oligemic areas and the penumbra is still debatable. Signal changes of fluid-attenuated inversion recovery image within DWI lesions may be a surrogate marker for ischemic lesion age and might indicate risks of hemorrhage after thrombolysis. Clot sign on gradient echo image may reflect the nature of clot, and their location, length and morphology may provide predictive information on recanalization by reperfusion therapy. However, previous clinical trials which solely or mainly relied on perfusion-diffusion mismatch for patient selection, failed to show benefits of MRI-based thrombolysis. Therefore, understanding the clinical implication of various useful MRI findings and comprehensively incorporating those variables into therapeutic decision-making may be a more reasonable approach for expanding the indication of acute stroke thrombolysis.
목차
등록된 정보가 없습니다.
참고문헌 (24)
참고문헌 신청
Baird AE. / 1998 / Magnetic resonance imaging of acute stroke / J Cereb Blood Flow Metab 18 : 583 ~ 609
Balami JS. / 2013 / Stroke syndromes and clinical management / QJM 106 : 607 ~ 615
Bergui M. / 2004 / Progressive multifocal leukoencephalopathy : diffusion-weighted imaging and pathological correlations / Neuroradiology 46 : 22 ~ 25
Campbell BC. / 2012 / Assessing response to stroke thrombolysis : validation of 24-hour multimodal magnetic resonance imaging / Arch Neurol 69 : 46 ~ 50
Chalela JA. / 2004 / Early magnetic resonance imaging findings in patients receiving tissue plasminogen activator predict outcome : Insights into the pathophysiology of acute
Balami JS. / 2013 / Stroke syndromes and clinical management / QJM 106 : 607 ~ 615
Bergui M. / 2004 / Progressive multifocal leukoencephalopathy : diffusion-weighted imaging and pathological correlations / Neuroradiology 46 : 22 ~ 25
Campbell BC. / 2012 / Assessing response to stroke thrombolysis : validation of 24-hour multimodal magnetic resonance imaging / Arch Neurol 69 : 46 ~ 50
Chalela JA. / 2004 / Early magnetic resonance imaging findings in patients receiving tissue plasminogen activator predict outcome : Insights into the pathophysiology of acute
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