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15.06.2018 | Computertomografie | Leitthema

Bildgebung beim akuten ischämischen Schlaganfall unter Verwendung automatisierter Analysealgorithmen

verfasst von: Dr. K. Egger, Dr. C. Strecker, Dr. E. Kellner, Prof. Dr. H. Urbach

Erschienen in: Der Nervenarzt | Ausgabe 8/2018

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Zusammenfassung

Es existieren mehrere automatische Analyseverfahren mit der Zielsetzung, mittels einer multimodalen CT- oder MRT-Bildgebung den thromboembolischen Gefäßverschluss, den Infarktkern und das potenziell infarktgefährdete Gewebe („tissue at risk“) darzustellen. Der Infarktkern wird mit DWI-MRT oder CT-Perfusion zuverlässiger als mit der nativen CT dargestellt. Die „Tissue-at-risk“-Ausdehnung und -Gefährdung kann nur abgeschätzt werden. Wesentlich erscheint aber, ob überhaupt „tissue at risk“ vorliegt. Um eine einheitliche Patientenversorgung zu gewährleisten, sollten einheitliche Bildgebungsprotokolle im zuweisenden und Thrombektomie-Krankenhaus akquiriert und die erhobenen Daten standardisiert und automatisiert ausgewertet und dargestellt werden. Ob Patienten mit großem Infarktkern und mit oder ohne „tissue at risk“ oder Patienten mit großen Gefäßverschlüssen, aber niedrigem NIHSS von der Thrombektomie profitieren, muss mithilfe standardisierter Bildgebung in kontrollierten klinischen Studien überprüft werden. Ein vielversprechender Ansatz ist auch, ein natives CT und CT-Angiogramm mit der Beurteilung des Gefäßverschlusses und der leptomeningealen Kollateralen mit einer Flachdetektor-Angiographie-Anlage zu erstellen.

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Titel: Bildgebung beim akuten ischämischen Schlaganfall unter Verwendung automatisierter Analysealgorithmen
verfasst von: Dr. K. Egger
Dr. C. Strecker
Dr. E. Kellner
Prof. Dr. H. Urbach
Publikationsdatum: 15.06.2018
Verlag: Springer Medizin
Schlagwörter: Computertomografie
Apoplex
Computertomografie
Gefäß-CT
Thrombektomie
Erschienen in: Der Nervenarzt / Ausgabe 8/2018
Print ISSN: 0028-2804
Elektronische ISSN: 1433-0407
DOI: https://doi.org/10.1007/s00115-018-0535-z

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