급성 허혈성 뇌졸중에서의 뇌 영상 검사의 최신 지견과 역할 = Neuroimaging in Acute Ischemic Stroke: Role and Recent Advances

다국어 초록 (Multilingual Abstract)

Neuroimaging plays a key role in assessing the detection of acute hemorrhage, diagnosis of infarct core, detection of steno-occlusive arteries, mismatch between infarct core and penumbra, and collateral circulation in patients with acute cerebral ischemic stroke. The recent announcement of randomized clinical trials that demonstrated the usefulness of intra-arterial mechanical thrombectomy and the guidelines of 2018 Guidelines for the Early Management of Patients with Acute Ischemic Stroke from American Heart Association/American Stroke Association led to a larger role of neuroimaging and required new neuroimaging strategy for acute cerebral ischemic stroke. In this review, we summarize the recommendation on neuroimaging from the 2018 Guidelines, and review pros and cons between CT and MR and fast scanned stroke MR. Based on the new guidelines and recent research, we discuss the appropriate neuroimaging strategy for acute cerebral ischemic stroke patients.

국문 초록 (Abstract)

뇌 영상 검사는 급성 허혈성 뇌졸중 환자의 뇌출혈 배제, 뇌경색 진단, 폐색 혈관의 검출, 관류상태와 뇌경색 간의 불일치 정도, 측부 순환 상태를 평가하는 핵심적인 역할을 한다. 최근 동맥 내 재개통술의 효용성을 증명한 무작위 배정 임상시험과 함께 이를 반영한 2018년 미국뇌졸중협회 가이드라인이 발표되면서 급성 허혈성 뇌졸중 환자의 진단과 치료 대상 선별을 위한 뇌 영상 검사의 역할은 더욱 커졌고 이에 시간에 따라 다른 영상의학적 전략이 중요해졌다. 이에 2018년 미국뇌졸중협회 가이드라인의 영상의학적 권고안을 요약하고 주요 뇌 영상검사인 CT와 MR의 역할과 장·단점 및 MR의 단점 극복을 위한 고속촬영 기법에 대해 기술하고자 한다. 아울러 새로운 가이드라인과 최근의 연구를 바탕으로 급성 허혈성 뇌졸중 환자를위한 적절한 영상의학적 전략에 대해 논하고자 한다.

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