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Georg Gahn MD (auth.), RÜdiger von Kummer MD, Tobias Back MD's Magnetic Resonance Imaging in Ischemic Stroke PDF

By Georg Gahn MD (auth.), RÜdiger von Kummer MD, Tobias Back MD (eds.)

ISBN-10: 3540008616

ISBN-13: 9783540008613

ISBN-10: 3540277382

ISBN-13: 9783540277385

The imaging of stroke has gone through major adjustments because of the swift growth in imaging know-how. This quantity, comprising 3 components, is designed to supply a entire precis of the present function of MR imaging in sufferers with ischemic stroke. the 1st half outlines the scientific shows of stroke and discusses the diagnostic efficacy and healing influence of MR imaging. the second one and 3rd elements shape the middle of the quantity, and are in accordance with a singular method in that the subject is gifted from very diversified viewpoints. half 2 offers an in depth presentation of the distinguishing positive factors of stroke from the radiologist's point of view. in contrast, half three addresses the wishes of the clinician, documenting particular stroke syndromes and their correlates on MR imaging. the final target has been to create a well-illustrated quantity with huge charm that hyperlinks pathology, radiology and stroke medication in an informative manner.

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Download e-book for kindle: Magnetic Resonance Imaging in Ischemic Stroke by Georg Gahn MD (auth.), RÜdiger von Kummer MD, Tobias Back MD

The imaging of stroke has passed through major adjustments due to the fast development in imaging know-how. This quantity, comprising 3 components, is designed to supply a finished precis of the present function of MR imaging in sufferers with ischemic stroke. the 1st half outlines the scientific shows of stroke and discusses the diagnostic efficacy and healing influence of MR imaging.

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The perfusion (PI) lesion delineates the extent of hypoperfusion and the diffusion (DWI) lesion outlines the infarct core. The difference between the two lesions (perfusion-diffusion mismatch) represents the ischaemic penumbra, tissue at risk of progression to infarction. b Patient imaged at 3 h after onset of left hemiparesis and neglect with large PI (time to peak - TTP) lesion and smaller DWI lesion. At day 3 reperfusion has not occurred and the infarct core (diffusion lesion) has expanded greatly into the region of acute perfusion-diffusion mismatch.

1998, 2001). This area deserves further study. There seems little doubt that trials of neuroprotective drugs, of which there have been many negative results to date, might be more likely to succeed if patients with an ischaemic penumbra were selected using perfusion-diffusion mismatch (Lees et al. 2000; Muir and Lees 1995; Yamaguchi et al. 1998). This has a rational basis, as neuroprotective drugs are targeted at ‘preserving’ the penumbra (Davis and Donnan 2002; Fisher and Brott 2003). 2 PI/DWI as Surrogate Markers of Treatment Response – ‘Proof of Concept’ As well as using PI/DWI to select an ‘ideal’ patient population to optimise the chances of efficacy of a therapeutic agent, PI/DWI may also have a role in the monitoring of ischaemic lesion evolution and therapeutic response in acute stroke trials.

2001). In general, they have found that the number of voxels with an ADC < 550 × 10 –6 mm2/s is the best predictor. However, this is essentially a marker of overall DWI lesion volume (Selim et al. 2002). The problem with these predictors is that there is no absolute cut-off DWI/ADC lesion volume, and the overlap between patients with and without HT is significant. In our experience, an acute DWI lesion volume > 100 cm3 (or qualitatively greater than 50% of the MCA territory) particularly if it is associated with no perfusion-diffusion mismatch (and regardless of vessel status on MRA), should probably be a contraindication to thrombolysis (Fig.

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Magnetic Resonance Imaging in Ischemic Stroke by Georg Gahn MD (auth.), RÜdiger von Kummer MD, Tobias Back MD (eds.)


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