State-of-the-art imaging of acute stroke

Ashok Srinivasan, Mayank Goyal, Faisal Al Azri, Cheemun Lum

Research output: Contribution to journalReview article

165 Citations (Scopus)

Abstract

Stroke is a leading cause of mortality and morbidity in the developed world. The goals of an imaging evaluation for acute stroke are to establish a diagnosis as early as possible and to obtain accurate information about the intracranial vasculature and brain perfusion for guidance in selecting the appropriate therapy. A comprehensive evaluation may be performed with a combination of computed tomography (CT) or magnetic resonance (MR) imaging techniques. Unenhanced CT can be performed quickly, can help identify early signs of stroke, and can help rule out hemorrhage. CT angiography and CT perfusion imaging, respectively, can depict intravascular thrombi and salvageable tissue indicated by a penumbra. These examinations are easy to perform on most helical CT scanners and are increasingly used in stroke imaging protocols to decide whether intervention is necessary. While acute infarcts may be seen early on conventional MR images, diffusion-weighted MR imaging is more sensitive for detection of hyperacute ischemia. Gradient-echo MR sequences can be helpful for detecting a hemorrhage. The status of neck and intracranial vessels can be evaluated with MR angiography, and a mismatch between findings on diffusion and perfusion MR images may be used to predict the presence of a penumbra. The information obtained by combining various imaging techniques may help differentiate patients who do not need intravenous or intraarterial therapy from those who do, and may alter clinical outcomes.

Original languageEnglish
JournalRadiographics
Volume26
Issue numberSPEC. ISS.
DOIs
Publication statusPublished - Oct 2006

Fingerprint

Stroke
Magnetic Resonance Spectroscopy
Tomography
Perfusion
Hemorrhage
Diffusion Magnetic Resonance Imaging
Perfusion Imaging
Spiral Computed Tomography
Magnetic Resonance Angiography
Thrombosis
Neck
Ischemia
Magnetic Resonance Imaging
Morbidity
Mortality
Brain
Therapeutics

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

State-of-the-art imaging of acute stroke. / Srinivasan, Ashok; Goyal, Mayank; Al Azri, Faisal; Lum, Cheemun.

In: Radiographics, Vol. 26, No. SPEC. ISS., 10.2006.

Research output: Contribution to journalReview article

Srinivasan, A, Goyal, M, Al Azri, F & Lum, C 2006, 'State-of-the-art imaging of acute stroke', Radiographics, vol. 26, no. SPEC. ISS.. https://doi.org/10.1148/rg.26si065501
Srinivasan, Ashok ; Goyal, Mayank ; Al Azri, Faisal ; Lum, Cheemun. / State-of-the-art imaging of acute stroke. In: Radiographics. 2006 ; Vol. 26, No. SPEC. ISS.
@article{bc68934dad03442c9b3978e6dfa9fda5,
title = "State-of-the-art imaging of acute stroke",
abstract = "Stroke is a leading cause of mortality and morbidity in the developed world. The goals of an imaging evaluation for acute stroke are to establish a diagnosis as early as possible and to obtain accurate information about the intracranial vasculature and brain perfusion for guidance in selecting the appropriate therapy. A comprehensive evaluation may be performed with a combination of computed tomography (CT) or magnetic resonance (MR) imaging techniques. Unenhanced CT can be performed quickly, can help identify early signs of stroke, and can help rule out hemorrhage. CT angiography and CT perfusion imaging, respectively, can depict intravascular thrombi and salvageable tissue indicated by a penumbra. These examinations are easy to perform on most helical CT scanners and are increasingly used in stroke imaging protocols to decide whether intervention is necessary. While acute infarcts may be seen early on conventional MR images, diffusion-weighted MR imaging is more sensitive for detection of hyperacute ischemia. Gradient-echo MR sequences can be helpful for detecting a hemorrhage. The status of neck and intracranial vessels can be evaluated with MR angiography, and a mismatch between findings on diffusion and perfusion MR images may be used to predict the presence of a penumbra. The information obtained by combining various imaging techniques may help differentiate patients who do not need intravenous or intraarterial therapy from those who do, and may alter clinical outcomes.",
author = "Ashok Srinivasan and Mayank Goyal and {Al Azri}, Faisal and Cheemun Lum",
year = "2006",
month = "10",
doi = "10.1148/rg.26si065501",
language = "English",
volume = "26",
journal = "Radiographics",
issn = "0271-5333",
publisher = "Radiological Society of North America Inc.",
number = "SPEC. ISS.",

}

TY - JOUR

T1 - State-of-the-art imaging of acute stroke

AU - Srinivasan, Ashok

AU - Goyal, Mayank

AU - Al Azri, Faisal

AU - Lum, Cheemun

PY - 2006/10

Y1 - 2006/10

N2 - Stroke is a leading cause of mortality and morbidity in the developed world. The goals of an imaging evaluation for acute stroke are to establish a diagnosis as early as possible and to obtain accurate information about the intracranial vasculature and brain perfusion for guidance in selecting the appropriate therapy. A comprehensive evaluation may be performed with a combination of computed tomography (CT) or magnetic resonance (MR) imaging techniques. Unenhanced CT can be performed quickly, can help identify early signs of stroke, and can help rule out hemorrhage. CT angiography and CT perfusion imaging, respectively, can depict intravascular thrombi and salvageable tissue indicated by a penumbra. These examinations are easy to perform on most helical CT scanners and are increasingly used in stroke imaging protocols to decide whether intervention is necessary. While acute infarcts may be seen early on conventional MR images, diffusion-weighted MR imaging is more sensitive for detection of hyperacute ischemia. Gradient-echo MR sequences can be helpful for detecting a hemorrhage. The status of neck and intracranial vessels can be evaluated with MR angiography, and a mismatch between findings on diffusion and perfusion MR images may be used to predict the presence of a penumbra. The information obtained by combining various imaging techniques may help differentiate patients who do not need intravenous or intraarterial therapy from those who do, and may alter clinical outcomes.

AB - Stroke is a leading cause of mortality and morbidity in the developed world. The goals of an imaging evaluation for acute stroke are to establish a diagnosis as early as possible and to obtain accurate information about the intracranial vasculature and brain perfusion for guidance in selecting the appropriate therapy. A comprehensive evaluation may be performed with a combination of computed tomography (CT) or magnetic resonance (MR) imaging techniques. Unenhanced CT can be performed quickly, can help identify early signs of stroke, and can help rule out hemorrhage. CT angiography and CT perfusion imaging, respectively, can depict intravascular thrombi and salvageable tissue indicated by a penumbra. These examinations are easy to perform on most helical CT scanners and are increasingly used in stroke imaging protocols to decide whether intervention is necessary. While acute infarcts may be seen early on conventional MR images, diffusion-weighted MR imaging is more sensitive for detection of hyperacute ischemia. Gradient-echo MR sequences can be helpful for detecting a hemorrhage. The status of neck and intracranial vessels can be evaluated with MR angiography, and a mismatch between findings on diffusion and perfusion MR images may be used to predict the presence of a penumbra. The information obtained by combining various imaging techniques may help differentiate patients who do not need intravenous or intraarterial therapy from those who do, and may alter clinical outcomes.

UR - http://www.scopus.com/inward/record.url?scp=34250714896&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34250714896&partnerID=8YFLogxK

U2 - 10.1148/rg.26si065501

DO - 10.1148/rg.26si065501

M3 - Review article

VL - 26

JO - Radiographics

JF - Radiographics

SN - 0271-5333

IS - SPEC. ISS.

ER -