Advances in imaging-based management of acute ischemic stroke now provide crucial information such as infarct core, ischemic penumbra/degree of collaterals, vessel occlusion, and thrombus that helps in the selection of the best candidates for reperfusion therapy. It also predicts thrombolytic efficacy and benefit or potential hazards from therapy. Thus, radiologists should be familiar with various imaging studies for patients with acute ischemic stroke and the applicability to clinical trials. This helps radiologists to obtain optimal rapid imaging as well as its accurate interpretation. This review is focused on imaging studies for acute ischemic stroke, including their roles in recent clinical trials and some guidelines to optimal interpretation.
Brain/blood supply/radiography ; Brain Infarction/*radiography/*therapy ; Cerebral Angiography/methods ; Diagnostic Imaging ; Diffusion Magnetic Resonance Imaging/*methods ; Fibrinolytic Agents/*therapeutic use ; Humans ; Intracranial Hemorrhages/diagnosis/radiography

OBJECTIVETo investigate the relationship of the acupoint and its functional location in the brain.

METHODSTen healthy participants were examined with the resting state functional magnetic resonance imaging (fM-RI). The scanning includes the resting state 1 (R 1), acupuncture stimulating (AP) Neiguan (PC 6) and the resting state 2 (R 2). All data were analyzed with the amplitude of low frequency fluctuations (ALFF).

RESULTS1) During the R1, the regions with active signal on the ALFF contained bilateral superior frontal gyrus, medial frontal gyrus and some part of cerebellum (including right declive, culme, tonsil and left uvula), as well as left precuneus, right superiour temporal gyrus. 2) As for AP, the active regions with higher ALFF were bilateral superior frontal gyrus and right cuneus, as well as left middle frontal gyrus, declivis and right semi-lunar lobule. 3) The main difference on ALFF between R1 and AP appeared within bilateral cingulated gyrus and declivis, left lingualgurus, and cuneus, as well as right precuneus, fusiform gyrus, superior frontal gyrus, medial frontal gyrus and superior temporal gyrus, etc.

CONCLUSIONAfter acupuncture stimulating the left Neiguan (PC 6), the active regions on ALFF are detected on bilateral cingulated gyrus, right superior frontal gyrus and medial frontal gyrus, as well as bilateral declivis and left lingual gurus, etc. These regions have the close relationship with the mental disorder and nervous diseases, which might be the possible neural mechanism of acupuncture stimulating Neiguan (PC 6) for treating some of related mental disorder and nervous diseases.

Acupuncture Points ; Brain ; blood supply ; diagnostic imaging ; metabolism ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Oxygen ; blood ; Radiography ; Young Adult

To explore the effect of cerebral function imaging in research on the acupoints specificity. Relevant literatures are retrieved and their results are compared. The results reveals as the follows: (1) Acupuncture can ameliorate cerebral blood flow hypoperfusion in patients with cerebrovascular disease, which maybe one of the mechanisms of acupuncture effect; (2) Acupuncture treatment has selectivity regulation role, which is related to the state of body and brain; (3) Cerebral function imaging can draw a clear distinction between therapeutic effect and placebo effect of acupuncture; (4) The points have specificity on the brain activation, but the outcomes are not exactly the same under different experimental conditions. Cerebral function imaging can be used to exploring acupoints specificity. Due to many interference factors which influence the accuracy of experiment, the subsequent experimental design have to be improved in the days ahead so as to make the results more cogent and rigorous.
Acupuncture Points ; Acupuncture Therapy ; Brain ; blood supply ; diagnostic imaging ; physiopathology ; Brain Mapping ; Cerebrovascular Circulation ; Humans ; Magnetic Resonance Imaging ; Positron-Emission Tomography ; Radiography

To evaluate the efficacy of magnetic resonance imaging in brainstem stroke, we studied 21 cases of clinically definite brainstem ischemic stroke with brain magnetic resonance imaging (MRI) and conventional computed tomography (CT). MRI demonstrated brainstem lesions in 79% of the cases (16.5 out of 21), while CT revealed 33% (7 out of 21) when cases with suspicious lesions counted as 0.5. Although MRI was done a few days later than CT in most cases, MRI was superior to CT in detecting the number and the size of ischemic lesions, with clear delineation of anatomy and visualization of the status of the blood flow in the vertebral-basilar artery. Disappearance of the flow signal void in the basilar artery can be an important clue in diagnosing occlusion or thrombus of the basilar artery. By delineating the extent and the location of the infarction, MRI findings allowed an interpretation of whether the ischemic vessel is a small basilar branch or a large vessel vertebral or basilar artery.
Adult ; Aged ; Brain Ischemia/complications/*diagnosis/radiography ; Brain Stem/blood supply/*pathology/radiography ; Cerebral Infarction/etiology/pathology ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Tomography, X-Ray Computed

The regional cerebral blood flow of four patients with delayed carbon monoxide sequelae and four age matched controls was measured, using a xenon inhalation CT scan (GE 9800). Variable patterns of decreased cerebral blood perfusion according to the clinical state of the patient were noted among the patients. Follow up studies, 2 months later, indicated that there was a correlation between the fluctuation of symptoms and the changes in regional cerebral blood flow. It is suggested that the impairment of cerebral perfusion may play a critical role in delayed carbon monoxide sequelae.
Administration, Inhalation ; Aged ; Brain/*blood supply ; Brain Ischemia/chemically induced/physiopathology/*radiography ; Carbon Monoxide Poisoning/*complications ; Case Report ; Female ; Human ; Male ; Middle Age ; Regional Blood Flow/drug effects ; Support, Non-U.S. Gov't ; Time Factors ; Tomography, X-Ray Computed ; Xenon/administration and dosage/diagnostic use

A Dieulafoy lesion in the rectum is a very rare and it can cause massive lower gastrointestinal bleeding. An 83-year-old man visited our hospital. He had chronic constipation and had taken aspirin for about 10 years because of a previous brain infarction. He was admitted because of a recent brain stroke. On the third hospital day, he had massive hematochezia and suddenly developed hypovolemic shock. Abdominal computed tomography showed active arterial bleeding on the left side of the mid-rectum. Emergency sigmoidoscopy showed an exposed vessel with blood spurting from the rectal wall. The active bleeding was controlled successfully by an injection of epinephrine and two hemoclippings. On the fourth day after the procedure, he had massive recurrent hematochezia, and his vital signs were unstable. Doppler-guided hemorrhoidal artery band ligation was performed urgently at two sites. However, he rebled on the third postoperative day. Selective inferior mesenteric angiography revealed an arterial pseudoaneurysm in a branch of the superior rectal artery, as the cause of rectal bleeding, and this was embolized successfully. We report a rare case of life-threatening rectal bleeding caused by a Dieulafoy lesion combined with pseudoaneurysm of the superior rectal artery which was treated successfully with embolization.
Aged, 80 and over ; Aneurysm/radiography ; Angiography ; Aspirin/therapeutic use ; Brain Infarction/drug therapy/prevention & control ; Embolization, Therapeutic ; Gastrointestinal Hemorrhage/*diagnosis/etiology/therapy ; Hemorrhoids/*complications ; Humans ; Male ; Mesenteric Artery, Inferior/radiography ; Platelet Aggregation Inhibitors/therapeutic use ; Rectal Diseases/complications/diagnosis/therapy ; Rectum/blood supply ; Sigmoidoscopy ; Tomography, X-Ray Computed

A Dieulafoy lesion in the rectum is a very rare and it can cause massive lower gastrointestinal bleeding. An 83-year-old man visited our hospital. He had chronic constipation and had taken aspirin for about 10 years because of a previous brain infarction. He was admitted because of a recent brain stroke. On the third hospital day, he had massive hematochezia and suddenly developed hypovolemic shock. Abdominal computed tomography showed active arterial bleeding on the left side of the mid-rectum. Emergency sigmoidoscopy showed an exposed vessel with blood spurting from the rectal wall. The active bleeding was controlled successfully by an injection of epinephrine and two hemoclippings. On the fourth day after the procedure, he had massive recurrent hematochezia, and his vital signs were unstable. Doppler-guided hemorrhoidal artery band ligation was performed urgently at two sites. However, he rebled on the third postoperative day. Selective inferior mesenteric angiography revealed an arterial pseudoaneurysm in a branch of the superior rectal artery, as the cause of rectal bleeding, and this was embolized successfully. We report a rare case of life-threatening rectal bleeding caused by a Dieulafoy lesion combined with pseudoaneurysm of the superior rectal artery which was treated successfully with embolization.
Aged, 80 and over ; Aneurysm/radiography ; Angiography ; Aspirin/therapeutic use ; Brain Infarction/drug therapy/prevention & control ; Embolization, Therapeutic ; Gastrointestinal Hemorrhage/*diagnosis/etiology/therapy ; Hemorrhoids/*complications ; Humans ; Male ; Mesenteric Artery, Inferior/radiography ; Platelet Aggregation Inhibitors/therapeutic use ; Rectal Diseases/complications/diagnosis/therapy ; Rectum/blood supply ; Sigmoidoscopy ; Tomography, X-Ray Computed