Computed tomography and magnetic resonance perfusion imaging in ischemic stroke: definitions and thresholds.

作者: Krishna A Dani , Ralph GR Thomas , Francesca M Chappell , Kirsten Shuler , Mary J MacLeod

DOI: 10.1002/ANA.22500

关键词: Cerebral infarctionCerebral perfusion pressureMagnetic resonance imagingPerfusionCerebral blood flowStrokePerfusion scanningRadiologyInfarctionMedicine

摘要: Objective: Cerebral perfusion imaging with computed tomography (CT) or magnetic resonance (MR) is widely available. The optimum values to identify tissue at risk of infarction in acute stroke are unclear. We systematically reviewed CT and MR ischemic stroke. Methods: searched for papers on performed <24 hours after that assessed thresholds, mean lesion values, volumes. extracted definitions values. compared evaluated thresholds ‘‘nonviable’’/’’at risk’’ ‘‘at risk’’/’’not tissue’’ thresholds. Results: Among 7,152 papers, 69 met inclusion criteria analysis (49 20 CT), 21 (n ¼ 551), 10 266) median sample size 22, provided found multiple states, eg, risk, 18; nonviable tissue, 12; 16, no definition. Perfusion parameters varied widely; 9 different MR, 6 the threshold.’’ Median threshold up 4-fold, threshold,’’ cerebral blood flow ranged from 18 37ml/100g/min; transit time 1.8 8.3 seconds relative contralateral side. influence reperfusion duration ischemia could not be assessed. Interpretation: viability derived small numbers patients, variable methods states. Greater consistency would help determine reliable wider clinical use imaging. ANN NEUROL 2011;70:384–401

参考文章(109)
R. Lagalla, B. Assadi, G. Sparacia, A. Iaia, Perfusion CT in acute stroke: predictive value of perfusion parameters in assessing tissue viability versus infarction Radiologia Medica. ,vol. 112, pp. 113- 122 ,(2007) , 10.1007/S11547-007-0125-9
L. Roccatagliata, L.H. Schwamm, W. Koroshetz, P.W. Schaefer, C. Ledezma, B. Hoh, M.H. Lev, R.G. Gonzalez, First-Pass Quantitative CT Perfusion Identifies Thresholds for Salvageable Penumbra in Acute Stroke Patients Treated with Intra-arterial Therapy American Journal of Neuroradiology. ,vol. 27, pp. 20- 25 ,(2006)
Yelda Ozsunar, Walter J. Koroshetz, Leena M. Hamberg, Pamela W. Schaefer, George J. Hunter, Julian He, R. Gilberto Gonzalez, A. Gregory Sorensen, Assessing tissue viability with MR diffusion and perfusion imaging. American Journal of Neuroradiology. ,vol. 24, pp. 436- 443 ,(2003)
Jens Fiehler, Joachim Röther, Hermann Zeumer, Susanne Wegener, Thomas Kucinski, René Knab, Amitava Majumder, Volker Schoder, Dirk Naumann, Tissue at risk is overestimated in perfusion-weighted imaging: MR imaging in acute stroke patients without vessel recanalization. American Journal of Neuroradiology. ,vol. 26, pp. 815- 819 ,(2005)
N. Hjort, K. Butcher, S.M. Davis, C.S. Kidwell, W.J. Koroshetz, J. Röther, P.D. Schellinger, S. Warach, L. Østergaard, Magnetic Resonance Imaging Criteria for Thrombolysis in Acute Cerebral Infarct Stroke. ,vol. 36, pp. 388- 397 ,(2005) , 10.1161/01.STR.0000152268.47919.BE
Hans-Jörg Wittsack, Afra Ritzl, Gereon R. Fink, Frank Wenserski, Mario Siebler, Rüdiger J. Seitz, Ulrich Mödder, Hans-Joachim Freund, MR imaging in acute stroke: diffusion-weighted and perfusion imaging parameters for predicting infarct size. Radiology. ,vol. 222, pp. 397- 403 ,(2002) , 10.1148/RADIOL.2222001731