Neuroimaging of Acute Ischemic Stroke: Current State
https://doi.org/10.18705/2311-4495-2019-6-2-12-17
Abstract
Over the past decade, there has been a significant improvement in neuroimaging techniques to improve the early diagnosis of acute stroke. Computed tomography and magnetic resonance imaging are often used in intracerebral hemorrhage or to evaluate contraindications to thrombolysis, to detect the localization of the ischemic area and to estimate the time of stroke. With the availability of fast and advanced imaging techniques, there is a growing interest in their application to predict success and eliminate the risks of specific therapy.
This review examines the existing methods of neuroimaging in acute strokes. To interpret the results of neuroimaging, it is important to know the clinical picture. In addition, the time factor, from the onset of stroke to collateral blood supply, should be incorporated into existing imaging-based therapeutic strategies.
About the Authors
R. Kh. Aldatov
Almazov National Medical Research Centre
Russian Federation
Competing Interests:
Russian Federation
Aldatov Ruslan Kh. - Postgraduate Student of the Department of Radiology and Medical Imaging.
Akkuratova str. 2, Saint Petersburg, 197341
Competing Interests:
No conflict of interest
G. E. Trufanov
Almazov National Medical Research Centre
Russian Federation
Competing Interests:
Russian Federation
Trufanov Gennady E. - MD, PhD, Dr. Sc., Professor, Head of the Research Department of Radiology, Head of the Department of Radiology and Medical Imaging.
Saint PetersburgCompeting Interests:
No conflict of interest
V. A. Fokin
Almazov National Medical Research Centre
Competing Interests:
Fokin Vladimir A. - MD, PhD, Dr. Sc., Professor, Head of Radiology Department.
Saint PetersburgCompeting Interests:
No conflict of interest
References
1. Best AC, Acosta NR, Fraser JE et al. Recognizing False Ischemic Penumbras in CT Brain Perfusion Studies. Radiographics. 2012;32(4):П79-П96.
2. Hacke W, Furlan AJ, Al-Rawi Y et al. Intravenous Desmoteplase in Patients with Acute Ischaemic Stroke Selected by MRI Perfusion-Diffusion Weighted Imaging or Perfusion CT (DIAS-2): A Prospective, Randomised, Double-Blind, Placebo-Controlled Study. Lancet Neurol. 2009;8(2):141-150.
3. Ahmed N, Kellert L, Lees KR et al. Results of Intravenous Thrombolysis Within 4.5 to 6 Hours and Updated Results within 3 to 4.5 Hours of Onset of Acute Ischemic Stroke Recorded in the Safe Implementation of Treatment in Stroke International Stroke Thrombolysis Register (SITS-ISTR): An Observational Study. JAMA Neurol. 2013;70(7):837-844.
4. de Los Rios la Rosa F, Khoury J, Kissela BM et al. Eligibility for Intravenous Recombinant Tissue-Type Plasminogen Activator within a Population: The Effect of the European Cooperative Acute Stroke Study (ECASS) III Trial. Stroke. 2012;43(6):1591-1595.
5. Musuka TD, Wilton SB, Traboulsi M et al. Diagnosis and Management of Acute Ischemic Stroke: Speed is Critical. CMAJ. 2015;187(12):887-893.
6. Hacke W, Donnan G, Fieschi C et al. Association of Outcome with Early Stroke Treatment: Pooled Analysis of ATLANTIS, ECASS, and NINDS rt-PA Stroke Trials. Lancet. 2004;363(9411):768-774.
7. Ferrari J, Knoflach M, Seyfang L et al. Differences in Process Management and In-Hospital Delays in Treatment with iv Thrombolysis. PLoS One. 2013;8(9):e75378.
8. Mohan S, Agarwal M, Pukenas B. Computed Tomography Angiography of the Neurovascular Circulation. Radiol Clin North Am. 2016;54(1):147-162.
9. McVerry F, Liebeskind DS, Muir KW. Systematic Review of Methods for Assessing Leptomeningeal Collateral Flow. AJNR Am J Neuroradiol. 2012;33(3):576-582.
10. Hochberg AR, Young GS. Cerebral Perfusion Imaging. Semin Neurol. 2012;32(4):454-465.
11. Xu S, Wang L, Zhao L. Clinical Application Value of Brain CT Perfusion Imaging in the Treatment of Acute Ischemic Stroke Thrombolytic Therapy. Exp Ther Med. 2019;17(5):3971-3976.
12. Campbell BC, Christensen S, Levi CR et al. Comparison of Computed Tomography Perfusion and Magnetic Resonance Imaging Perfusion-Diffusion Mismatch in Ischemic Stroke. Stroke. 2012;43(10):2648-2653.
13. Burton KR, Dhanoa D, Aviv RI et al. Perfusion CT for Selecting Patients with Acute Ischemic Stroke for Intravenous Thrombolytic Therapy. Radiology. 2015;274(1):103-114.
14. Michel P, Ntaios G, Reichhart M et al. Perfusion-CT Guided Intravenous Thrombolysis in Patients with Unknown-Onset Stroke: A Randomized, Double-Blind, Placebo-Controlled, Pilot Feasibility Trial. Neuroradiology. 2012;54(6):579-588.
15. Fedorov MA, Diomidova VN, Migushkina LP. The Role of Magnetic Resonance Imaging in Improving the Quality of Medical Care Patients with Ischemic Stroke. Prakticheskaya medicina=Practical medicine. 2015;6(91):115—118.
16. Meuree C, Maurel P, Ferre JC et al. Patch-Based Super-Resolution of Arterial Spin Labeling Magnetic Resonance Images. Neuroimage. 2019;189:85-94.
17. Hendrikse J, Petersen ET, Golay X. Vascular Disorders: Insights from Arterial Spin Labeling. Neuroimaging Clin N Am. 2012;22(2):259-269,x-xi.
18. Zaharchuk G. Arterial Spin Labeling for Acute Stroke: Practical Considerations. Transl Stroke Res. 2012;3(2):228-235.
19. Griebe M, Fischer E, Kablau M et al. Thrombolysis in Patients with Lacunar Stroke is Safe: An Observational Study. J Neurol. 2014;261(2):405-411.
20. Wintermark M, Sanelli PC, Albers GW et al. Imaging Recommendations for Acute Stroke and Transient Ischemic Attack Patients: A Joint Statement by the American Society of Neuroradiology, the American College of Radiology and the Society of NeuroInterventional Surgery. J Am Coll Radiol. 2013;10(11):828-832.
21. Fokin vA, Yanishevskii SN, Trufanov AG. MRI in the Diagnosis of Ischemic Stroke. SPb: ELBI-SPb. 2012. p. 96. In Russian [Фокин В. А., Янишевский С. Н., Труфа-нов А. Г МРТ в диагностике ишемического инсульта. СПб.: ЭЛБИ-СПб. 2012. с. 96].
22. Moreau F, Asdaghi N, Modi J et al. Magnetic Resonance Imaging Versus Computed Tomography in Transient Ischemic Attack and Minor Stroke: The More You See the More You Know. Cerebrovasc Dis Extra. 2013;3(1):130-136.
23. Kidwell CS, Wintermark M, De Silva DA et al. Multiparametric MRI and CT Models of Infarct Core and Favorable Penumbral Imaging Patterns in Acute Ischemic Stroke. Stroke. 2013;44(1):73-79.
24. Forster A, Griebe M, Wolf ME et al. How to Identify Stroke Mimics in Patients Eligible for Intravenous Thrombolysis? J Neurol. 2012;259(7):1347-1353.
25. Madai VI, Wood CN, Galinovic I et al. Clinical-Radiological Parameters Improve the Prediction of the Thrombolysis Time Window by Both MRI Signal Intensities and DWI-FLAIR Mismatch. Cerebrovasc Dis. 2016;42(1-2):57-65.
26. Tong E, Hou Q, Fiebach JB et al. The Role of Imaging in Acute Ischemic Stroke. Neurosurg Focus. 2014;36(1):E3.
27. Kawano H, Hirano T, Nakajima M et al. Diffusion-Weighted Magnetic Resonance Imaging May Underestimate Acute Ischemic Lesions: Cautions on Neglecting a Computed Tomography-Diffusion-Weighted Imaging Discrepancy. Stroke. 2013;44(4):1056-1061.
28. Hirano T Searching for Salvageable Brain: The Detection of Ischemic Penumbra Using Various Imaging Modalities? J Stroke Cerebrovasc Dis. 2014;23(5):795-798.
29. Stinear CM, Ward NS. How Useful is Imaging in Predicting Outcomes in Stroke Rehabilitation? Int J Stroke. 2013;8(1):33-37.
30. Campbell BC, Purushotham A, Christensen S et al. The Infarct Core is Well Represented by the Acute Diffusion Lesion: Sustained Reversal is Infrequent. J Cereb Blood Flow Metab. 2012;32(1):50-56.
31. Maksimova MYu, Domashenko MA, Krotenkova MV et al. Neuroimaging in the Evaluation of Indications for Thrombolysis. Proceedings National Congress “Emergency Conditions in Neurology”. 2009:114-115.
32. 32 Kushwaha S, Malik S, Sarraf G et al. Thrombolysis in Recurrent Stroke-Beyond Guidelines: A Case Report. J Stroke Cerebrovasc Dis. 2014;23(8):e407-e408.
33. Davis S, Donnan GA. Time is Penumbra: Imaging, Selection and Outcome. The Johann Jacob Wepfer Award 2014. Cerebrovasc Dis. 2014;38(1):59-72.
34. Deprez N, De Herdt V, Vandersteene J et al. Delayed Intravenous Thrombolysis Based on MRI Mismatch in Posterior Circulation Stroke. Acta Neurol Belg. 2014;114(2):113-115.
35. Tisserand M, Naggara O, Legrand L et al. Patient “Candidate” for Thrombolysis: MRI is Essential. Diagn Interv Imaging. 2014;95(12):1135-1144.
36. Albers GW, Thijs Vn, Wechsler L et al. Magnetic Resonance Imaging Profiles Predict Clinical Response to Early Reperfusion: The Diffusion and Perfusion Imaging Evaluation for Understanding Stroke Evolution (DEFUSE) Study. Ann Neurol. 2006;60(5):508-517.
37. Davis SM, Donnan GA, Parsons MW et al. Effects of Alteplase Beyond 3 h After Stroke in the Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET): A Placebo-Controlled Randomised Trial. Lancet Neurol. 2008;7(4):299-309.
38. Dani KA, Thomas RG, Chappell FM et al. Computed Tomography and Magnetic Resonance Perfusion Imaging in Ischemic Stroke: Definitions and Thresholds. Ann Neurol. 2011;70(3):384-401.
39. Bivard A, Krishnamurthy V, Stanwell P et al. Arterial Spin Labeling Versus Bolus-Tracking Perfusion in Hyperacute Stroke. Stroke. 2014;45(1):127-133.
40. Mlynash M, Lansberg mG, De Silva DA et al. Refining the Definition of the Malignant Profile: Insights from the DEFUSE-EPITHET Pooled Data Set. Stroke. 2011;42(5):1270-1275.
41. Lansberg MG, Straka M, Kemp S et al. MRI Profile and Response to Endovascular Reperfusion After Stroke (DEFUSE 2): A Prospective Cohort Study. Lancet Neurol. 2012;11(10):860-867.
42. Albers GW, Marks MP, Kemp S et al. Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging. N Engl J Med. 2018;378(8):708-718.
43. Ginsberg MD. The Cerebral Collateral Circulation: Relevance to Pathophysiology and Treatment of Stroke. Neuropharmacology. 2018;134(Pt B):280-292.
Review
For citations:
Aldatov R.Kh., Trufanov G.E., Fokin V.A. Neuroimaging of Acute Ischemic Stroke: Current State. Translational Medicine. 2019;6(2):12-17. (In Russ.) https://doi.org/10.18705/2311-4495-2019-6-2-12-17
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