By Rüdiger von Kummer, Tobias Back, K. Sartor
Presents a complete precis of the present position of MR imaging in sufferers with ischemic stroke. particularly designed to fulfill the wishes of either clinicians and radiologists. files the MR correlates of particular stroke syndromes. comprises many top quality illustrations.
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Additional resources for Magnetic Resonance Imaging in Ischemic Stroke
Overall, the sensitivity and specificity of DWI for ischemic lesions in acute stroke (< 24 hours) is very high, although false-negative DWI is more common in the posterior fossa (Ay et al. 1999; Lovblad et al. 1998; Oppenheim et al. 2000). In hyperacute stroke, the false-negative DWI rate may be above 10%, even in the anterior circulation (Sunshine et al. 2001). In this time window, combining PI with DWI provides essential diagnostic and therapy-guiding information that DWI alone does not. 3 Vertebrobasilar Stroke The great majority of hyperacute stroke MRI studies have been limited to patients with supratentorial ischaemia.
The DWI lesion may overestimate the infarct core and be partially reversible Haefelin et al. 1999; Parsons et al. 2001). However, these PI maps significantly overestimate final infarct size (Fig. 7) (Parsons et al. 2001). How to best distinguish between penumbra and benign oligaemia at the border of the perfusion lesion has been the subject of intense research and debate. A range of perfusion (and apparent diffusion coefficient) thresholds have been identified that distinguish between penumbra and benign oligaemia with varying degrees of accuracy (Fig.
The future holds great promise. It is only a matter of time before MRI routinely assists the stroke clinician in making individual therapeutic decisions, and guides stroke researchers in identifying effective therapies that can be delivered well beyond the current 3-h window. References Abciximab in Ischemic Stroke Investigators (2000) Abciximab in acute ischemic stroke: a randomized, double-blind, placebo-controlled, dose-escalation study. Stroke 31:601–609 Albers GW, Clark WM (1999) For the ATLANTIS Study Investigators.