Imaging and treatment response after ischaemic stroke.

摘要

Use of brain imaging to predict treatment response after ischaemic stroke, a test of which is reported by Maarten Lansberg and colleagues1 in this issue of The Lancet Neurology, has a long history. In 1993, Gilles Marchal and colleagues2 used information about both blood flow and metabolic activity obtained with PET to predict differentia! clinical outcomes. They identified three outcome groups: first, when perfusion was normal or increased and metabolism was normal, clinical outcome was uniformly favourable, and spontaneous recanalisation was assumed to have occurred; second, when blood flow was severely reduced and brain metabolism in the ischaemic region was very low, clinical outcomes were uniformly poor: irreversible damage had already occurred; and third, when perfusion was reduced but oxygen consumption was reduced although still present, clinical outcomes were variable.