Zusammenfassung
Thema dieser Übersichtsarbeit ist die CT-basierte Diagnostik bei Patienten mit akutem ischämischem Schlaganfall. Anhand mehrerer Beispiele wird vor allem die diagnostische Wertigkeit des „multiparametrischen” Schlaganfall-CT-Protokolls diskutiert. Zum Protokoll gehören Nativ-CT, Perfusions-CT und CT-Angiographie. Neben der Nativ-CT können Perfusions-CT und CT-Angiographie schnell zusätzliche Informationen über die zerebrale Perfusion und den arteriellen Gefäßstatus liefern, ohne dass der Patient umgelagert werden muss. Diese Zusatzuntersuchungen verzögern den Therapiebeginn zwar minimal, können jedoch entscheidend bei der Patientenselektion für eine Thrombolysetherapie helfen.
Abstract
The topic of this article is the CT-based diagnosis of hyperacute ischemic stroke. Several examples are used to discuss the diagnostic role of the „multiparametric” stroke CT protocol, which combines nonenhanced CT (NECT), perfusion CT (PCT), and CT angiography (CTA), without moving the patient. In hyperacute stroke, the multiparametric CT protocol provides wide-ranging information on cerebral perfusion and the cerebral arterial system. These additional examinations barely delay the initiation of therapy and can be decisive in selecting patients for thrombolytic therapy. When MRI is not available, multiparametric stroke CT can give nearly equivalent information and is significantly more comprehensive than NECT alone.
Key words
Acute stroke - Computed tomography - CT-angiography - Perfusion CT - Multislice CT - Stroke CT protocol
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Dr. med. Peter Schramm
Neurologische Klinik · Abt. Neuroradiologie · Universitätsklinikum Heidelberg
Im Neuenheimer Feld 400 · 69120 Heidelberg
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