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Recent advances in magnetic resonance imaging for stroke diagnosis
Radhika Rastogi1, Yuchuan Ding1, Shuang Xia2, Meiyun Wang3, Yu Luo4, Hyun Seok Choi5, Zhaoyang Fan6, Meng Li7, Timothy D Kwiecien1, Ewart Mark Haacke8
1 Department of Neurological Surgery, Wayne State University, School of Medicine, Detroit, Michigan, USA
2 Department of Radiology, Tianjin First Central Hospital, Tianjin, China
3 Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China
4 Department of Radiology, The Branch of Shanghai First Hospital, Shanghai, China
5 Department of Radiology, The Catholic University of Korea, St. Mary's Hospital, Seoul, Korea
6 Department of Biomedical Sciences, Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
7 Department of Radiology, Wayne State University, School of Medicine, Detroit, Michigan, USA
8 Department of Radiology, Wayne State University, School of Medicine, Detroit, Michigan, USA; Department of Medical Imaging, University of Saskatchewan, Saskatoon, Canada; Department of Biomedical Engineering, Northeast University, Shenyang; Department of Physics, East China Normal University, Shanghai, China
Correspondence Address:
Yuchuan Ding
Department of Neurological Surgery, School of Medicine, Wayne State University, 550 E Canfield, Detroit, Michigan - 48201, USA
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/2394-8108.164996
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In stroke, diagnosis and identification of the infarct core and the penumbra is integral to therapeutic determination. With advances in magnetic resonance imaging (MRI) technology, stroke visualization has been radically altered. MRI allows for better visualization of factors such as cerebral microbleeds (CMBs), lesion and penumbra size and location, and thrombus identification; these factors help determine which treatments, ranging from tissue plasminogen activator (tPA), anti-platelet therapy, or even surgery, are appropriate. Current stroke diagnosis standards use several MRI modalities in conjunction, with T2- or T2*- weighted MRI to rule out intracerebral hemorrhage (ICH), magnetic resonance angiography (MRA) for thrombus identification, and the diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) mismatch for penumbral identification and therapeutic determination. However, to better clarify the neurological environment, susceptibility-weighted imaging (SWI) for assessing oxygen saturation and the presence of CMBs as well as additional modalities, such as amide proton transfer (APT) imaging for pH mapping, have emerged to offer more insight into anatomical and biological conditions during stroke. Further research has unveiled potential for alternative contrasts to gadolinium for PWI as well, as the contrast has contraindications for patients with renal disease. Superparamagnetic iron oxide nanoparticles (SPIONs) as an exogenous contrast and arterial spin labeling (ASL) as an endogenous contrast offer innovative alternatives. Thus, emerging MRI modalities are enhancing the diagnostic capabilities of MRI in stroke and provide more guidance for patient outcome by offering increased accessibility, accuracy, and information. |
