Scientific Online Resource System

Scripta Scientifica Medica

State-of-the-Art Imaging in Acute Ischemic Cerebral Infarction

MB Penkov


BACKGROUND:In order to take advantage of the latest treatment options andkeeping in mind that„time is brain`in stroke management, the goal of imaging istodiagnose as early as possible,obtain accurate informationaboutthe cerebrovascular systemandbrain tissue perfusion, select the correct therapyand improve the outcome of one of the most debilitating and costly to society diseases.


  • to describe the basics of CT and MR techniques used to evaluate stroke;
  • to determine an imaging protocol for acute stroke evaluation;
  • to recognize the significance of a penumbra for therapy and prognosis after acute stroke.

MAIN BODY:Overall evaluation can be performed with computed tomography (CT)and/or magnetic resonance (MR).

Native CT can be performed rapidly to identify the early signs of ischemia and to exclude haemorrhage. CT angiography and CT perfusion, may display intravascular thrombosis and thepenumbra. These tests are easy to performonmost spiral CT devices and are increasingly used in patients with IMI to decide on the type and volume ofthenecessary intervention.

Although acute attacks can be seen at the start of the conventional MRI, diffusion isthemost sensitiveseriesfor the detection ofhyperacute ischemia.

Gradient-echo MR sequences can be useful for detecting bleeding;the neck and intracranial vessels can be assessed with MR angiography, and the presence of „mismatch` between the diffusion and perfusion can predict the existence of the penumbra.

CONCLUSION:Imaging technology has advanced rapidly in the past two decades, and current imaging techniques can be used to identify hyperacute stroke and guide therapy by providing information about the functional status of ischemic brain tissue. Both CT and MR imaging are useful for the comprehensive evaluation of acute stroke and can provide important and necessary information for therapy planning.


computed tomography, magnetic resonance, penumbra, acute stroke

Article Tools
Email this article (Login required)
About The Author

MB Penkov

Font Size