脳卒中超急性期における画像診断プロトコール

We described our imaging protocol for apoplexy to select a therapeutic way. The recent advance of MR technology much contributes to diagnosis of cerebral ischemic disease. Especially the EPI method is now applied to clinical MR machine and make possible to obtain diffusion-weighted images (DWI) with excellent quality, which can detect super-acute phase of cerebral infarction. Then we choose MRI as the first modality conducted for patients of apoplexy and measured DWI and perfusion MRI before conducting conventional cerebral angiography. The mismatch area between DWI and perfusion MRI will suggest the necessity of re-circulation therapy because rescuable neuronal cells from ischemia will exist in the mismatch area. Furthermore cerebral hemorrhage can be detected using EPI-T2 weighted images and DWI, and the luxury perfusion will be also evaluated by perfusion MRI. Therefore we considered that MR examination could be the first modality conducted for diagnosis of cerebral vascular accident of acute phase.