再灌注治疗的神经影像学评估 Neuroimaging Evaluation of Reperfusion Therapy

Abstract

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。 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.

Keywords

• 急性缺血性卒中
• 再灌注治疗
• 神经影像学
• 缺血半暗带
• acute ischemic stroke
• reperfusion therapy
• neuroimaging
• ischemic penumbra