IMIDŽING STRATEGIJA U AKUTNOM ISHEMIJSKOM MOŽDANOM UDARU: DIJAGNOSTIČKI IZAZOV
Sažetak
Akutni ishemijski moždani udar je treći vodeći uzrok smrti i najčešći uzrok trajne invalidnosti u svetu. Različiti modaliteti imidžinga imaju važnu ulogu u evaluaciji parenhima mozga i intrakranijalnih krvnih sudova u akutnom ishemijskom moždanom udaru.
Angio- i perfuziona kompjuterska tomografija (CT) imaju široku primenu zbog dostupnosti širom sveta. Međutim, MRI difuzioni imidžing (DWI) omogućava ranije i preciznije otkrivanje ishemije i koristi se zajedno sa drugim sekvencama protokola, kao što su imidžing susceptibilnosti (SWI), 3D MR angiografija 3D (MRA) i kontrastna MRA supraortalnih arterija (CE-MRA), što omogućava dijagnostikovanje okludiranih arterija ili otkrivanje hemoragije, kao i lokalizaciju tromboze. Pomoću nekontrastne perfuzije, sekvence arterijskog obeležavanja spinova (ASL), koja je od posebnog interesa, moguće je dijagnostikovati ishemijsku penumbru i predvideti prognozu ishoda na neinvazivan način.
MRI je najtačnija i najpouzdanija tehnika za dijagnostikovanje ishemijskog moždanog udara i u kombinaciji sa ASL sekvencom, značajna je za diferencijaciju ovog stanja od drugih bolesti, poput epilepsije i migrene. Međutim, CT može biti značajna alternativa u slučaju da MR nije dostupan ili je kontraindikovan.
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