Ces radiol. 2007, 61(3):231-241

Imaging of acute brain ischaemiaReview article

Jiří Ferda, Jan Kastner, Boris Kreuzberg, Milan Novák, Vladimír Rohan1
1 Radiodiagnostická klinika LF UK a FN, Plzeň
2 Neurologická klinika LF UK a FN, Plzeň

Stroke is characterized by a sudden neurological deficit caused by intracranial haemorrhage or ischaemia. Neuroimaging enables the identification of patients with acute infarction and stratification of treatment, the assessment of tissue at risk of infarction, the determination of etiology and the follow up of the therapy and any complications.
Because of its availability, computed tomography (CT) plays a primary role in the imaging of patients with acute stroke and still remains the gold standard for the detection of cerebral haemorrhage. Although many infarcts cannot be detected on non-enhanced CT until hours after the onset of stroke, other techniques such as perfusion CT (pCT) and CT-angiography (CTA) improve the detectability of early infarction. Despite the leading role of CT in the evaluation of the ischaemia in the anterior circulation, the detection of ischaemia in the posterior circulation remains problematic and MRI is challenging its position. The optimal MRI protocol in cases of acute stroke includes diffusion-weighted imaging (DWI) to show acute ischaemic lesions, MR-angiography (MRA) to visualize the brain's arterial system and perfusion MRI studies to estimate brain perfusion. New possibilities offered by MRI, such as functional magnetic resonance (fMRI) or diffusion tensor imaging (DTI), are assessed to predict the final neurological deficit of the brain infarction.
The aim of the all imaging procedures is the careful selection of patients suitable for thrombolytic therapy. This selection is crucial in order to improve the safety and efficacy of this targeted causal therapy.

Keywords: stroke, brain perfusion, computed tomography (CT), CT-angiography (CTA), magnetic resonance imaging (MRI), diffusion-weighted imaging (DWI), functional magnetic resonance (fMRI), diffusion tensor imaging (DTI)
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Práce byla podpořena výzkumným projektem MSM 0021620819.

Accepted: July 15, 2007; Published: September 1, 2007  Show citation

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Ferda J, Kastner J, Kreuzberg B, Novák M, Rohan V. Imaging of acute brain ischaemia. Ces radiol. 2007;61(3):231-241.
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