MR imaging in hyperacute ischemic stroke

Vert, Carla; Parra-Fariñas, Carmen

doi:10.1016/j.ejrad.2017.06.013

Cited by 31 publications

(27 citation statements)

References 40 publications

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“…Although there are no published thresholds for the infarct core and penumbra, the following criteria have been generally used: a decrease in CBF of 30-50% (5,7,22,45,46); cerebral blood volume less than 2 to 2.5 g/100 mL relative to the normal cerebral hemisphere for the infarct core (45,47,48); a Tmax delay of more than 6 seconds for the penumbra for CTP and DWI lesions for the infarct core (6,10,16); and a Tmax delay of more than 6 seconds for the penumbra on MRP (49). However, if imaging protocols or modalities are not standardized or synchronized, reliability cannot be guaranteed regardless of the threshold or postprocessing software used.…”

Section: Discussionmentioning

confidence: 99%

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Neuroimaging in Randomized, Multi-Center Clinical Trials of Endovascular Treatment for Acute Ischemic Stroke: A Systematic Review

et al. 2020

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Appropriate use and analysis of neuroimaging techniques is an inevitable aspect of clinical trials for patients with acute ischemic stroke. Neuroimaging examinations were recently used to define the core eligibility criteria and outcomes in acute ischemic stroke research. Recent clinical trials for endovascular treatment in acute ischemic stroke have also demonstrated the efficacy or safety of endovascular treatment using various imaging modalities as well as clinical indices. Furthermore, independent imaging reviews and imaging core laboratory assessments are essential to manage and analyze imaging data in order to enhance the reliability of the outcomes. Therefore, we systematically reviewed the use of neuroimaging in recent randomized clinical trials for endovascular treatment of acute ischemic stroke in order to provide a thorough summary, which would serve as a resource guiding the use of appropriate imaging protocols and analyses in future clinical trials for acute ischemic stroke. This review will help researchers select appropriate imaging biomarkers among the various imaging protocols available and apply the selected type of imaging examination for each study in accordance with the academic purpose.

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Section: Discussionmentioning

confidence: 99%

“…NECT and GRE are the main sequences used for evaluation of hemorrhagic transformation, but GRE is much more sensitive than NECT for the detection of hemorrhage (49,51). Therefore, in studies focusing on hemorrhagic transformation, GRE may be another imaging option.…”

Section: Discussionmentioning

confidence: 99%

Neuroimaging in Randomized, Multi-Center Clinical Trials of Endovascular Treatment for Acute Ischemic Stroke: A Systematic Review

et al. 2020

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“…This leads to missed diagnoses of ischemic stroke that may not be confirmed until additional imaging, such as an MRI, is performed hours later or even the following day. 3,4 Hyperacute MRI brain at the time of stroke patient presentation is not commonly available, 80 and a stroke sensor device with high sensitivity for ischemia would help to alleviate the limitations of CT for evaluation of acute non-LVO ischemic stroke. As outlined in this review, there are many forms of technology under development currently as non-invasive external brain monitoring devices.…”

Section: Discussionmentioning

confidence: 99%

Non-invasive sensor technology for prehospital stroke diagnosis: Current status and future directions

Walsh

2019

International Journal of Stroke

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Background The diagnosis of stroke in the prehospital environment is the subject of intense interest and research. There are a number of non-invasive external brain monitoring devices in development that utilize various technologies to function as sensors for stroke and other neurological conditions. Future increased use of one or more of these devices could result in substantial changes in the current processes for stroke diagnosis and treatment, including transportation of stroke patients by emergency medical services. Aims The present review will summarize information about 10 stroke sensor devices currently in development, utilizing various forms of technology, and all of which are external, non-invasive brain monitoring devices. Summary of review Ten devices are discussed including the technology utilized, the indications for use (stroke and, when relevant, other neurological conditions), the environment(s) indicated for use (with a focus on the prehospital setting), a description of the physical structure of each instrument, and, when available, findings that have been published in peer-reviewed journals or otherwise reported. The review is organized based on the technology utilized by each device, and seven distinct forms were identified: accelerometers, electroencephalography (EEG), microwaves, near-infrared, radiofrequency, transcranial doppler ultrasound, and volumetric impedance phase shift spectroscopy. Conclusions Non-invasive external brain monitoring devices are in various stages of development and have promise as stroke sensors in the prehospital setting. Some of the potential applications include to differentiate stroke from non-stroke, ischemic from hemorrhage stroke, and large vessel occlusion (LVO) from non-LVO ischemic stroke. Successful stroke diagnosis prior to hospital arrival could transform the current diagnostic and treatment paradigm for this disease.

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“…Comparing to CT, MRI displays superior sensitivity for detecting small symptomatic ischemic lesions, and to discern them from chronic lesions, even when localized in the brainstem and in the cerebellum. 29 Although characterized by a lower sensitivity for detecting brain ischemia, computed tomographers are widespread, efficient, and readily available diagnostic instruments for emergency situations. CT main advantages with respect to MRI are mainly linked to the faster acquisition times (about 1-2 min for non-enhanced CT; around 10 min when combining non-enhanced CT with dynamic CT perfusion and CT angiography).…”

Section: Magnetic Resonance Imaging (Mri)mentioning

confidence: 99%