Magnetresonanztomographie beim Schlaganfall - Methodische Grundlagen und klinische Anwendung

Zusammenfassung.

Der Schlaganfall ist die dritthäufigste Todesursache. Bis vor wenigen Jahren gab es kein diagnostisches Verfahren, das eine Darstellung des ischämisch geschädigten Hirngewebes in der therapeutisch entscheidenden Frühphase ermöglichte. Seit Anfang der neunziger Jahre hat sich das grundlegend geändert: Mit der Entwicklung der Perfusions- und der Diffusions-MRT für in vivo Messungen stehen inzwischen diagnostische Werkzeuge zur Verfügung, mit denen sich die zerebrale Ischämie unmittelbar nach dem Gefäßverschluß erfassen läßt, und zwar durch den Nachweis von Störungen der Mikrozirkulation (Perfusions-MRT) und der Zellschädigung (Diffusions-MRT). Durch Kombination von Perfusions- und Diffusions-Meßtechniken mit der MR-Standardmethodik (T₂-gewichtete Sequenzen, MR-Angiographie) ergibt sich ein Untersuchungsprotokoll für MRT beim Schlaganfall, das komplementär über strukturelle und funktionelle Parameter informiert.

Stroke is the third leading cause of death. Until recently, no diagnostic technique was available that could reliably depict ischemic tissue within a therapeutically promising time window. Since the beginning of this decade, a fundamental change has taken place: Perfusion- and diffusion-MRI have shown to be capable of depicting the ischemic injury immediately after vessel occlusion. While perfusion MRI is sensitive to abnormalities in cerebral capillary blood flow (microcirculation), diffusion MRI indicates tissue damage on a cellular level. Combining perfusion- and diffusion-MRI with standard MR techniques (T₂-weighted sequences, MR angiography) results in an MR protocol that is complementary and gives insight into both structural and functional parameters.

Zerebrale Ischämie - Perfusions-MRT - Diffusions-MRT - MR-Angiographie

Cerebral ischemia - Perfusion-MRI - Diffusion-MRI - MR angiography

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