Recommendations for Imaging of Acute Ischemic Stroke

On the Reproducibility of Inversion Recovery Intravoxel Incoherent Motion Imaging in Cerebrovascular Disease

“…1,2 This technique is sensitive to the microcirculatory condition and provides insight into the cerebral hemodynamics in, for example, patients with ischemic stroke. Because this technique is contraindicated in patients with impaired renal function, there is interest in techniques that avoid contrast agents.…”

CT Angiographic Source Images Predict Outcome and Final Infarct Volume Better Than Noncontrast CT in Proximal Vascular Occlusions

“…CTA-SI appears to be as sensitive as diffusion-weighted imaging in detecting acute ischemia. 8 We have previously shown that CTA-SI was superior to NCCT for predicting final infarct extent but was unable to show a definitive relationship with clinical outcomes. 9 Similarly, another study of 51 patients confirmed that CTA-SI has higher sensitivity than NCCT for detecting early irreversible ischemia and correlates better with final infarct volume.…”

Odyssey of Patent Foramen Ovale: Closure in Cryptogenic Stroke: The Canary in the Coal Mine of Clinical Trials?

“…First, expected rates of recurrence after cryptogenic stroke used to design these studies were based largely on population/epidemiologic studies from the 1990s and early 2000s 1. In the interim, technological improvements in neuroimaging (diffusion weighted magnetic resonance imaging, computed tomography angiography) and adoption of prolonged ECG monitoring and echocardiography into the workup for stroke7 likely increased the sensitivity of stroke diagnosis and the likelihood of identifying stroke etiology. These changes over time have resulted in a decrease in the both the percentage of strokes that are cryptogenic and the likelihood of stroke recurrence.…”