By K. Sartor, A. L. Baert

The imaging of stroke has passed through major adjustments as a result of the fast growth in imaging expertise. This quantity, comprising 3 elements, is designed to supply a complete precis of the present function of MR imaging in sufferers with ischemic stroke. the 1st half outlines the scientific displays of stroke and discusses the diagnostic efficacy and healing impression of MR imaging. the second one and 3rd elements shape the middle of the quantity, and are in response to a singular strategy in that the subject is gifted from very assorted viewpoints. half 2 presents a close presentation of the distinguishing positive factors of stroke from the radiologist's standpoint. in contrast, half three addresses the wishes of the clinician, documenting particular stroke syndromes and their correlates on MR imaging. the final target has been to create a well-illustrated quantity with vast attraction that hyperlinks pathology, radiology and stroke medication in an informative manner.

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Following thrombolysis, there is complete reperfusion and all mismatch tissue is salvaged from infarction on follow-up imaging 31 et al. 2002a). This is consistent with conventional angiographic data (Furlan et al. 1999). These results emphasise that thrombolysis should not be withheld from patients with distal arterial occlusion (if perfusion-diffusion mismatch is present), but also that alternative treatment approaches might need to be considered for patients with ICA or proximal MCA occlusion.

2001) 24 h 07 h 12 h 06 h 06 h Percentage with perfusiondiffusion mismatch 70% 80% at 6 hours 65% at 12 hours 50% at 24 hours 80% 50% 65% 80% 75% Type of PI map used to assess hypoperfusion First moment time First moment time Time to peak Time to peak Mean transit time and cerebral blood flow Time to peak Mean transit time and cerebral blood flow M. W. Parsons and S. M. Davis 28 a b Fig. 5a,b. a Patient imaged at 3 h after stroke onset. There is a large perfusion lesion and extensive perfusion-diffusion mismatch.

Simplistically, this relates to the fact that there is a non-linear relationship between contrast concentration and signal intensity with gadolinium-based PI (Calamante et al. 1999, 2002). Another major issue with perfusion thresholds is that they change with time. This has been demonstrated both experimentally, and in human stroke with PI (Butcher et al. 2003; Heiss 1983; Hossmann 1994; Hossmann et al. 1977). In research performed by our group, penumbral tissue with a contrast transit delay of up to 15 s was salvaged from infarction at 2 h after stroke onset, but at 6 h the threshold for salvage was less than 6 s delay in contrast transit (Fig.

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Magnetic Resonance Imaging in Ischemic Stroke by K. Sartor, A. L. Baert

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