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Imaging of Ischemic Stroke, An Issue of Neuroimaging Clinics - E-Book

Imaging of Ischemic Stroke, An Issue of Neuroimaging Clinics - E-Book

Alisa Gean

(2011)

Additional Information

Abstract

Topics include: Imaging of Ischemic Stroke; Hemorrhagic Stroke and Non-traumatic Intracranial Hemorrhage; Acute Neuro-Interventional Therapies; Orbital and Intracranial Complications of Sinusitis; Traumatic Brain Injury; Central Nervous System Infections; Facial Trauma: What the Surgeon Wants to Know; Intracranial Hypo- and Hypertension; Seizures; Pediatric Central Nervous System Emergencies; Spine Emergencies; Infections and Inflammatory Processes of the Neck

Table of Contents

Section Title Page Action Price
Front Cover Cover
Stroke Imaging i
Copyright Page ii
Neuroimaging Clinics of North America iv
Contributors v
Contents ix
Foreword xiii
Imaging Acute Stroke is Rapidly Evolving xv
Chapter 1. Advanced CT Imaging in the Evaluation of Hemorrhagic Stroke 197
ACCURACY OF MULTIDETECTOR CT ANGIOGRAPHY FOR THE DETECTION OF UNDERLYING VASCULAR LESIONS IN HEMORRHAGIC STROKE 198
THE CT ANGIOGRAPHY SPOT SIGN IN PRIMARY ICH 203
THE CT ANGIOGRAPHY SPOT SIGN IN SECONDARY INTRACEREBRAL HEMORRHAGE 209
SUMMARY 212
ACKNOWLEDGMENTS 212
REFERENCES 212
Chapter 2. CT Perfusion Imaging in Acute Stroke 215
TECHNICAL CONSIDERATIONS OF CTP 216
COMPARISON WITH MR-PWI 218
RADIATION DOSE IN CTP: FACTS, PUBLICITY, AND RESPONSE 220
CTP METHODOLOGY: GENERAL PRINCIPLES 220
CTP THEORY AND MODELING 221
CTP POSTPROCESSING 221
CORRECTION FOR DELAY AND DISPERSION OF THE AIF: WHY IT MATTERS 223
CLINICAL APPLICATIONS OF CTP 223
IMAGE INTERPRETATION: INFARCT DETECTION WITH CTA-SI 225
CTP INTERPRETATION: ISCHEMIC PENUMBRA AND INFARCT CORE 225
IMAGING PREDICTORS OF CLINICAL OUTCOME 229
SUMMARY 231
REFERENCES 232
Chapter 3. Stroke Imaging Research Road Map 239
THE NEED FOR STANDARDIZATION AND VALIDATION 239
THE STIR 240
SUMMARY 244
REFERENCES 244
Chapter 4. Role of Diffusion and Perfusion MRI in Selecting Patients for Reperfusion Therapies 247
DIFFUSION MRI 248
PERFUSION MRI 250
EVOLUTION OF MISMATCH DEFINITIONS AND CONCEPTS 251
TRIALS THAT TESTED AND USED THE DWI/PWI MISMATCH HYPOTHESIS DEFUSE 251
FUTURE DIRECTIONS 254
SUMMARY 255
REFERENCES 255
Chapter 5. MR Perfusion Imaging in Acute Ischemic Stroke 259
THE HEMODYNAMICS OF ISCHEMIC STROKE 260
DYNAMIC SUSCEPTIBILITY CONTRAST IMAGING: BASIC PHYSICS AND IMAGE ACQUISITION 261
DYNAMIC SUSCEPTIBILITY CONTRAST IMAGING: MEASUREMENT OF PERFUSION PARAMETERS 263
USING MR PERFUSION IMAGING IN PATIENT CARE 275
SUMMARY 278
REFERENCES 278
Chapter 6. Arterial Spin Label Imaging of Acute Ischemic Stroke and Transient Ischemic Attack 285
INDICATIONS FOR ASL PERFUSION IMAGING 288
PREVIOUS LITERATURE ON ASL FINDINGS IN TIA AND STROKE 288
TYPICAL FINDINGS ON ASL STUDIES: STROKE 292
TYPICAL FINDINGS ON ASL STUDIES: TIA 295
PROBLEMS WITH ASL IMAGING IN STROKE AND TIA 296
FUTURE OF ASL IN STROKE AND TIA 298
SUMMARY 299
REFERENCES 299
Chapter 7. Transient Ischemic Attack: Definition, Diagnosis, and Risk Stratification 303
CLINICAL DIAGNOSIS OF TIA 303
BRAIN IMAGING FINDINGS IN TIA 304
TISSUE-BASED DEFINITION OF TIA 307
PREDICTION OF STROKE RISK AFTER TIA 308
SUMMARY 311
REFERENCES 311
Chapter 8. Measuring Permeability in Acute Ischemic Stroke 315
MRI METHODS FOR THE ASSESSMENT OF BBB INTEGRITY 315
CT METHODS FOR THE ASSESSMENT OF BBB INTEGRITY 321
SUMMARY AND FUTURE DIRECTIONS FOR IMAGING ASSESSMENT OF BBB INTEGRITY 322
REFERENCES 323
Chapter 9. Imaging Stroke Patients with Unclear Onset Times 327
PATIENTS WITH UNCLEAR STROKE ONSETS: BACKGROUND 328
IMAGING-BASED TRIAGE FOR THERAPEUTIC INTERVENTION 331
CLINICAL TRIALS INVOLVING PATIENTS WITH UNWITNESSED STROKE ONSET 340
SUMMARY 340
REFERENCES 340
Chapter 10. MR Diffusion Imaging in Ischemic Stroke 345
BASIC CONCEPTS OF DIFFUSION MR IMAGING 345
BASIC MECHANISMS UNDERLYING RESTRICTED DIFFUSION ASSOCIATED WITH ACUTE STROKE 347
DIFFUSION-WEIGHTED IMAGING MAP INTERPRETATION 348
TIME COURSE OF DWI CHANGES ASSOCIATED WITH ACUTE ISCHEMIA 349
RELIABILITY AND PITFALLS OF DWI IN IDENTIFICATION OF ACUTE ISCHEMIC LESIONS 350
REVERSIBILITY OF DWI-POSITIVE LESIONS IN ISCHEMIC STROKE AND USE OF DWI FOR DETERMINATION OF INFARCT CORE 353
USE OF DWI FOR PREDICTING HEMORRHAGIC TRANSFORMATION 356
CORRELATION OF DWI LESION VOLUME WITH CLINICAL OUTCOME 358
DIFFUSION TENSOR IMAGING AND DIFFUSION KURTOSIS IMAGING 359
THE DIFFUSION TENSOR 359
THE DIFFUSION KURTOSIS TENSOR 361
DTI AND DKI IN THE NORMAL BRAIN 362
EVOLUTION OF MEAN DIFFUSION IN ISCHEMIA 363
EVOLUTION OF DIFFUSIONAL ANISOTROPY IN ISCHEMIA 363
DIFFUSIONAL KURTOSIS CHANGES IN ISCHEMIA 365
PREDICTING TISSUE VIABILITY AND CLINICAL OUTCOME 365
SECONDARY WHITE MATTER DEGENERATION 367
PERINATAL HYPOXIC-ISCHEMIC INJURY 368
SUMMARY 370
REFERENCES 370
Chapter 11. Intra-arterial Stroke Therapy: Recanalization Strategies, Patient Selection and Imaging 379
IMAGING TRIAGE 379
IAT 381
COMBINED IV THERAPY/IAT 384
MECHANICAL THROMBOLYSIS 384
STENT PLACEMENT/ANGIOPLASTY FOR STROKE TREATMENT 388
SUMMARY 389
REFERENCES 389
Chapter 12. Noninvasive Carotid Artery Imaging with a Focus on the Vulnerable Plaque 391
LUMINAL IMAGING 392
PLAQUE IMAGING 394
FUTURE DEVELOPMENTS 400
SUMMARY 400
ACKNOWLEDGMENTS 401
REFERENCES 401
Chapter 13. ASPECTS and Other Neuroimaging Scores in the Triage and Prediction of Outcome in Acute Stroke Patients 407
ASPECTS 407
POSTERIOR CIRCULATION NEUROIMAGING SCORES 415
THE CLOT BURDEN SCORE 416
THE BOSTON ACUTE STROKE IMAGING SCALE 417
LEPTOMENINGEAL COLLATERAL SCORES ON CTA 417
HOW CAN ASPECTS AND OTHER NEUROIMAGING SCORES BE USED IN CLINICAL DECISION MAKING? 418
THE GOOD-SCAN-OCCLUSION PARADIGM FOR PATIENT SELECTION IN FUTURE STROKE TRIALS 419
TRAINING IN THE USE OF ASPECTS AND OTHER NEUROIMAGING SCORES 420
SUMMARY 420
REFERENCES 420
Index 425