Neurological Surgery 脳神経外科48巻4号

2020年04月発行

総説

急性期脳梗塞における灌流画像の基礎と臨床応用

著者： 志村亮祐¹ 長内俊也² 工藤與亮¹

所属機関： ¹北海道大学病院放射線診断科 ²北海道大学大学院医学研究院脳神経外科

ページ範囲：P.295 - P.306

Ⅰ．はじめに
　近年の急性期脳梗塞の治療戦略においては，rt-PA（アルテプラーゼ）静注療法と機械的血栓回収療法の2つを柱とする再灌流療法が主軸となっており，その適応拡大が進んでいる．この流れの中で最近のガイドラインや多施設共同研究では，再灌流療法の適応判定に画像診断，特にCT灌流画像（CT perfusion imaging）やMR灌流画像（MR perfusion imaging）による虚血ペナンブラの評価が利用されるようになってきている．
　本稿では，急性期脳梗塞診療における最近の治療戦略の進歩と，その中で画像診断が果たす役割を述べる．また，急性期脳梗塞イメージングに関し，CT灌流画像，MR灌流画像を主として，その撮像原理や解析手法，自動解析ソフトについて解説する．

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