Advanced multimodal CT/MRI approaches to hyperacute stroke diagnosis, treatment, and monitoring

Ann N Y Acad Sci. 2012 Sep;1268:1-7. doi: 10.1111/j.1749-6632.2012.06719.x.

Abstract

Multimodal CT/MRI has dramatically changed the approach to ischemic stroke management, as noninvasive CT/MRI images detail brain tissue or parenchyma, angiography or vessel status, and collateral perfusion or blood flow in regions of the brain vulnerable to ischemic injury. Such snapshots of the dynamic process of cerebral ischemia may be used to gauge reversibility and therapeutic opportunities. Treatment of acute stroke may be rapidly tailored to clinical scenarios based on imaging correlation of ischemia, vessel status, and perfusion. Serial or repeated imaging from the initial presentation to later stages of the hospital course may illustrate infarct growth, persisting occlusion, reocclusion, recanalization, reperfusion, and hemorrhagic transformation. From acute stroke to rehabilitation phases and subsequent prevention, multimodal CT/MRI has emerged as a key tool to track the process of stroke and the impact of our therapeutic interventions.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Acute Disease
  • Brain / diagnostic imaging
  • Brain / pathology
  • Brain Ischemia / diagnosis*
  • Brain Ischemia / diagnostic imaging
  • Brain Ischemia / rehabilitation
  • Brain Ischemia / therapy
  • Cerebral Angiography / methods
  • Cerebral Hemorrhage / diagnosis
  • Cerebral Hemorrhage / etiology
  • Cerebral Hemorrhage / pathology
  • Cerebral Hemorrhage / prevention & control
  • Cerebral Revascularization
  • Cerebrovascular Circulation
  • Collateral Circulation
  • Emergencies
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Patient Selection
  • Secondary Prevention
  • Thrombolytic Therapy / adverse effects
  • Tomography, X-Ray Computed / methods*