急性缺血性卒中不同时间窗影像学评价及应用进展 Evaluation and Application of Medical Imaging for Acute Ischemic Stroke at Different Time Windows: A Review

Abstract

急性缺血性卒中（acute ischemic stroke，AIS）具有高致残率和高致死率特征，早期识别AIS和准确评估AIS的时间窗，对提高治疗效果具有重要意义。近年来，多模态影像技术指导的治疗时间窗评估在AIS的个体化精细管理中越来越被重视。明确AIS不同发病时间的影像特征，对早期识别AIS、评估AIS患者发病时间、判断病情动态变化以及指导再灌注治疗有重要意义。目前单一成像模式已经无法满足AIS精细化管理的临床需求，通过合理的多模态影像联合应用，能够更好地实现AIS的早期诊断、发病时间评估和预后评价。本文分别对AIS不同发病时间CT、MRI的影像学特征，多模态影像技术的应用价值和进展，以及机器学习和人工智能技术在AIS诊断和治疗中的潜在价值进行综述。 Abstract: Acute ischemic stroke (AIS) is characterized by high rates of disability and mortality. Early identification of AIS and accurate assessment of the time window for AIS are of great significance for improving the outcome. In recent years, the evaluation of the treatment time window guided by multimodal imaging technology has been increasingly concerned in the individualized and precise management of AIS. Clarifying the imaging characteristics of AIS at various onset time is crucial for early identification of AIS, accurate assessment of its onset time, evaluation of dynamic changes of the disease, and the effective guidance of reperfusion therapy. At present, a single imaging mode can no longer meet the clinical needs of precise management of AIS. Reasonable combined application of multimodal imaging can better achieve early diagnosis, onset time assessment, and prognosis evaluation of AIS. This paper reviewed the CT and MRI imaging characteristics of AIS at different onset time, the application value and progress of multimodal imaging technology, as well as the potential value of machine learning and artificial intelligence in the diagnosis and treatment of AIS.

Keywords

• 急性缺血性卒中
• 影像技术
• 多模态
• 发病至成像时间
• 人工智能
• acute ischemic stroke
• imaging technology
• multimodality
• onset-to-imaging time
• artificial intelligence