Recent advances in neuroimaging have demonstrated significant assessment benefits and appropriate triage of patients based on specific clinical and radiological features in the acute stroke setting. Endovascular thrombectomy is arguably the most important aspect of acute stroke management with an extended time window. Imaging-based physiological information may potentially shift the treatment paradigm from a rigid time-based model to a more flexible and individualized, tissue-based approach, increasing the proportion of patients amenable to treatment. Various imaging modalities are routinely used in the diagnosis and management of acute ischemic stroke, including multimodal computed tomography (CT) and magnetic resonance imaging (MRI). Therefore, these imaging methods should provide information beyond the presence or absence of intracranial hemorrhage as well as the presence and extent of the ischemic core, collateral circulation and penumbra in patients with neurological symptoms. Target mismatch may optimize selection of patients with late or unknown symptom onset who would potentially be eligible for revascularization therapy. The purpose of this study was to provide a comprehensive review of the current evidence about efficacy and theoretical basis of present imaging modalities, and explores future directions for imaging in the management of acute ischemic stroke.

中文翻译：

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急性缺血性卒中影像学进展：取栓前评估

神经影像学的最新进展表明，根据急性卒中环境中的特定临床和放射学特征，可以对患者进行显着的评估益处和适当的分类。血管内血栓切除术可以说是急性卒中管理中最重要的方面，具有延长的时间窗。基于成像的生理信息可能会将治疗​​范式从严格的基于时间的模型转变为更灵活和个性化的基于组织的方法，从而增加适合治疗的患者比例。各种成像方式常用于急性缺血性中风的诊断和管理，包括多模态计算机断层扫描 (CT) 和磁共振成像 (MRI)。所以，这些成像方法应该提供的信息超出了颅内出血的存在与否，以及有神经系统症状的患者的缺血核心、侧支循环和半暗带的存在和范围。靶点错配可以优化对可能有资格接受血运重建治疗的晚期或未知症状的患者的选择。本研究的目的是对当前成像方式的有效性和理论基础的当前证据进行全面回顾，并探索成像在急性缺血性卒中管理中的未来方向。靶点错配可以优化对可能有资格接受血运重建治疗的晚期或未知症状的患者的选择。本研究的目的是对当前成像方式的有效性和理论基础的当前证据进行全面回顾，并探索成像在急性缺血性卒中管理中的未来方向。靶点错配可以优化对可能有资格接受血运重建治疗的晚期或未知症状的患者的选择。本研究的目的是对当前成像方式的有效性和理论基础的当前证据进行全面回顾，并探索成像在急性缺血性卒中管理中的未来方向。