Advanced CT and MR Imaging of Acute Cerebral Infarction

• Published in: Contemporary diagnostic radiology Vol. 30; no. 10; pp. 1 - 5
• Main Authors: Comunale, Joseph P, Sanelli, Pina, Zimmerman, Robert D
• Format: Journal Article
• Language: English
• Published: Lippincott Williams & Wilkins, Inc 15-05-2007
• ISSN: 0149-9009; 1938-1395
• DOI: 10.1097/01.CDR.0000269607.16912.6c

Cerebral infarction is the third most common cause of death and the leading cause of disability in the United States. The only FDA-approved medical treatment option for acute cerebral infarction is intravenous recombinant tissue plasminogen activator (tPA) administered within 3 hours from the time of ictus. Although many patients benefit from intravenous tPA, most do not meet the criteria for treatment with tPA, predominantly because of delay in presentation so that stroke is diagnosed after the approved 3-hour therapeutic window. Advances in neuroimaging are helping to redefine and expand treatment options for acute cerebral infarction beyond this 3-hour span. Advanced CT and MR stroke imaging protocols now can be performed easily on commercially available equipment and can provide additional details about a cerebral infarction beyond whether or not it is present. A core of irreversibly damaged brain tissue can be distinguished from a surrounding penumbra of damaged but potentially salvageable “at risk” brain tissue. This ability to obtain further characterization of patients with stroke is being used at some medical centers to stratify patients into appropriate treatment groups.This article reviews imaging findings on noncontrast CT and conventional MR imaging and introduces advanced functional MR and CT protocols.