Aralin 1Pagpaliwanag ng perfusion imaging: core vs penumbra, Tmax, CBF, CBV thresholds at pitfallsAng seksyong ito ay nagdedetalye ng pagpaliwanag ng CT at MR perfusion, na nagkakaiba ng core mula sa penumbra gamit ang CBF, CBV, at Tmax maps, na sinuri ang karaniwang numeric thresholds, vendor differences, artifacts, at clinical pitfalls na maaaring magligtas ng maling desisyon sa paggamot.
Physiologic basis ng core at penumbraPagpaliwanag ng Tmax, CBF, at CBV mapKaraniwang numeric thresholds at caveatsArtifacts, motion, at truncation errorsChronic infarct at leukoaraiosis pitfallsAralin 2Guidelines at decision thresholds: major society recommendations para sa imaging selection at treatment windowsAng seksyong ito ay nagbubuod ng major guideline recommendations para sa acute stroke imaging, kabilang ang time windows para sa IV thrombolysis at thrombectomy, imaging-based selection lampas sa standard windows, at kung paano i-apply ang decision thresholds sa real-world practice.
Key AHA/ASA at ESO imaging guidanceImaging criteria para sa IV thrombolysisImaging criteria para sa thrombectomyLate-window at wake-up stroke imagingPagkakasundo ng guidelines sa local practiceAralin 3Komunikasyon sa stroke team: phrasing para sa thrombolysis at thrombectomy eligibility, recommended next imaging at monitoringAng seksyong ito ay nakatuon sa maikli, high-impact komunikasyon sa stroke team, kabilang ang standardized phrasing para sa thrombolysis at thrombectomy eligibility, uncertainty statements, recommended next imaging, at gabay sa monitoring at repeat studies.
Key elements ng stroke phone reportPhrasing eligibility para sa IV thrombolysisPhrasing eligibility para sa thrombectomyPagrekomenda ng next imaging stepsPagdedekumento ng uncertainty at follow-upAralin 4MRI protocols para sa hyperacute stroke: DWI, ADC, FLAIR, SWI, TOF/MRA, perfusion MRI parametersAng seksyong ito ay nagpapaliwanag ng MRI protocol design para sa hyperacute stroke, na nagdedetalye ng DWI at ADC para sa core, FLAIR para sa onset estimation, SWI para sa hemorrhage at thrombus, TOF/MRA para sa vessels, at perfusion MRI parameters na naayon sa time-critical decisions.
Pag-optimize ng DWI at ADC para sa ischemic coreFLAIR mismatch at stroke onset estimationSWI para sa microbleeds at susceptibility vessel signTOF at contrast MRA para sa vessel imagingPerfusion MRI: sequence choice at timingAralin 5Reporting structure para sa stroke code: critical findings, side at vascular territory, estimated core/penumbra, time-sensitive recommendationsAng seksyong ito ay naglalahad ng structured stroke code report, na nagbibigay-diin sa malinaw na paglalarawan ng hemorrhage, ischemic core at penumbra, occlusion site, side at vascular territory, at explicit, time-sensitive recommendations para sa thrombolysis, thrombectomy, at follow-up imaging.
Standardized report headings at sequencePagdedekumento ng hemorrhage at ischemic coreSide, vascular territory, at ASPECTS scoringPaglalahad ng thrombectomy at lysis eligibilityTime-stamped, actionable recommendationsAralin 6CT protocols: slice thickness, reconstruction, contrast timing para sa CTA, coverage para sa perfusionAng seksyong ito ay sumusuri ng noncontrast CT, CTA, at CT perfusion setup sa acute stroke, na nakatuon sa slice thickness, reconstruction kernels, contrast bolus timing, at perfusion coverage upang balansehin ang bilis, radiation dose, at diagnostic accuracy.
Noncontrast CT slice thickness at kernelsCTA acquisition timing at contrast bolusCT perfusion coverage at slab selectionRadiation dose, ASIR, at artifact reductionMotion management at patient positioningAralin 7Pagpili ng emergency imaging: noncontrast CT, CT angiography, CT perfusion at MRI alternativesAng seksyong ito ay sumusuri kung paano pumili ng emergency imaging pathways, na naghahambing ng noncontrast CT, CTA, CT perfusion, at MRI options batay sa time from onset, patient stability, contraindications, at local resources upang lumikha ng efficient, evidence-based algorithms.
Baseline noncontrast CT indicationsKailan magdagdag ng CTA sa first scanRole ng CT perfusion sa triageKailan MRI ang preferred o essentialPaggawa ng site-specific imaging algorithmsAralin 8Vascular occlusion assessment: site ng occlusion, collateral status, thrombus length at clot burden scoreAng seksyong ito ay nagpapaliwanag ng systematic assessment ng vascular occlusion, kabilang ang pagkilala ng occlusion site, clot length, collateral circulation, at clot burden scores sa CTA at MRA, at kung paano apektuhan ng mga faktong ito ang thrombectomy decisions at prognosis.
Pagkilala ng proximal versus distal occlusionsPagsusukat ng thrombus length sa CTACollateral grading systems at scoringClot burden score at prognosisImaging predictors ng recanalizationAralin 9False negatives at mimics: seizure, migraine, hypoglycemia, posterior fossa limitations at strategies upang mabawasan ang errorsAng seksyong ito ay tumutugon sa false negatives at stroke mimics, kabilang ang seizure, migraine, hypoglycemia, functional disorders, at posterior fossa strokes, at nagpapakita ng imaging strategies at protocol adjustments upang mabawasan ang diagnostic errors sa hyperacute setting.
Karaniwang clinical at imaging stroke mimicsSeizure at postictal imaging appearancesMigraine aura at perfusion abnormalitiesPosterior fossa stroke CT limitationsStrategies upang mabawasan ang false negativesAralin 10Key acute imaging signs: early ischemic changes, hyperdense vessel sign, territorial infarction patternsAng seksyong ito ay tumutakip sa key CT at MRI signs ng acute ischemia, kabilang ang early parenchymal changes, hyperdense vessel sign, loss of gray–white differentiation, sulcal effacement, at characteristic territorial infarct patterns na nagmama-map sa specific vascular distributions.
Early ischemic CT signs at ASPECTS useHyperdense artery sign at variantsLoss of gray–white differentiation patternsTerritorial infarct patterns by vascular territoryPosterior circulation at lacunar stroke signs
