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Review
. 2023 Oct 28;59(11):1908.
doi: 10.3390/medicina59111908.

Neuroimaging Modalities Used for Ischemic Stroke Diagnosis and Monitoring

Jasmin J Nukovic  1   2 , Valentina Opancina  3   4   5 , Elisa Ciceri  4 , Mario Muto  5 , Nebojsa Zdravkovic  6 , Ahmet Altin  7 , Pelin Altaysoy  8 , Rebeka Kastelic  9 , Diana Maria Velazquez Mendivil  10 , Jusuf A Nukovic  1   2 , Nenad V Markovic  11 , Miljan Opancina  6   12 , Tijana Prodanovic  13 , Merisa Nukovic  2 , Jelena Kostic  14 , Nikola Prodanovic  11
Affiliations
Review

Neuroimaging Modalities Used for Ischemic Stroke Diagnosis and Monitoring

Jasmin J Nukovic et al. Medicina (Kaunas). .

Abstract

Strokes are one of the global leading causes of physical or mental impairment and fatality, classified into hemorrhagic and ischemic strokes. Ischemic strokes happen when a thrombus blocks or plugs an artery and interrupts or reduces blood supply to the brain tissue. Deciding on the imaging modality which will be used for stroke detection depends on the expertise and availability of staff and the infrastructure of hospitals. Magnetic resonance imaging provides valuable information, and its sensitivity for smaller infarcts is greater, while computed tomography is more extensively used, since it can promptly exclude acute cerebral hemorrhages and is more favorable speed-wise. The aim of this article was to give information about the neuroimaging modalities used for the diagnosis and monitoring of ischemic strokes. We reviewed the available literature and presented the use of computed tomography, CT angiography, CT perfusion, magnetic resonance imaging, MR angiography and MR perfusion for the detection of ischemic strokes and their monitoring in different phases of stroke development.

Keywords: CT; MR; ischemia; neuroimaging; stroke.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study selection process.
Figure 2
Figure 2
Patient, male, 48 years old, presented with left hemiplegia and dysarthria at the emergency department, after which a neurologist ordered CT diagnostics. (A,B) Non-contrast CT which shows MCA hyperdensity (red circle), loss of right insular ribbon (white arrow) and ASPECT 9. (C,D) CT angiography, axial and sagittal, showing tandem occlusion of origin of R-ICA (dissection) and R-MCA (both in red circles). (E) CT perfusion showing mismatch volume of 105 mL.
Figure 3
Figure 3
Male patient, 45 years old, presented with vertigo and disorientation at the emergency department, after which a neurologist ordered neuroimaging. (A,B) Non-contrast CT shows hyperdense basilar artery (red circle). (C) CT angiography shows occlusion of basilar artery. (D). CT perfusion shows mismatch volume of 288 mL and marks ischemia zone. (E) MRI in sequences DWI and ADC show restricted diffusion in the right cerebellar region, marking acute ischemia.
See this image and copyright information in PMC

References

    1. Sacco R.L., Kasner S.E., Broderick J.P., Caplan L.R., Connors J.J., Culebras A., Elkind M.S., George M.G., Hamdan A.D., Higashida R.T., et al. An updated definition of stroke for the 21st century: A statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013;44:2064–2089. doi: 10.1161/STR.0b013e318296aeca. - DOI - PMC - PubMed
    1. Boehme A.K., Esenwa C., Elkind M.S. Stroke Risk Factors, Genetics, and Prevention. Circ. Res. 2017;120:472–495. doi: 10.1161/CIRCRESAHA.116.308398. - DOI - PMC - PubMed
    1. Maier O., Menze B.H., von der Gablentz J., Häni L., Heinrich M.P., Liebrand M., Winzeck S., Basit A., Bentley P., Chen L., et al. A public evaluation benchmark for ischemic stroke lesion segmentation from multispectral MRI. Med. Image Anal. 2017;35:250–269. doi: 10.1016/j.media.2016.07.009. - DOI - PMC - PubMed
    1. Xiong Y., Wakhloo A.K., Fisher M. Advances in Acute Ischemic Stroke Therapy. Circ. Res. 2022;130:1230–1251. doi: 10.1161/CIRCRESAHA.121.319948. - DOI - PubMed
    1. Nael K., Sakai Y., Khatri P., Prestigiacomo C.J., Puig J., Vagal A. Imaging-based Selection for Endovascular Treatment in Stroke. Radiographics. 2019;39:1696–1713. doi: 10.1148/rg.2019190030. - DOI - PubMed

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