کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4231838 1610158 2011 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
ACR Appropriateness Criteria® on Cerebrovascular Disease
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی رادیولوژی و تصویربرداری
پیش نمایش صفحه اول مقاله
ACR Appropriateness Criteria® on Cerebrovascular Disease
چکیده انگلیسی
Stroke is the sudden onset of focal neurologic symptoms due to ischemia or hemorrhage in the brain. Current FDA-approved clinical treatment of acute ischemic stroke involves the use of the intravenous thrombolytic agent recombinant tissue plasminogen activator given <3 hours after symptom onset, following the exclusion of intracerebral hemorrhage by a noncontrast CT scan. Advanced MRI, CT, and other techniques may confirm the stroke diagnosis and subtype, demonstrate lesion location, identify vascular occlusion, and guide other management decisions but, within the first 3 hours after ictus, should not delay or be used to withhold recombinant tissue plasminogen activator therapy after the exclusion of acute hemorrhage on noncontrast CT scans. MR diffusion-weighted imaging is highly sensitive and specific for acute cerebral ischemia and, when combined with perfusion-weighted imaging, may be used to identify potentially salvageable ischemic tissue, especially in the period >3 hours after symptom onset. Advanced CT perfusion methods improve sensitivity to acute ischemia and are increasingly used with CT angiography to evaluate acute stroke as a supplement to noncontrast CT. The ACR Appropriateness Criteria® are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of the American College of Radiology - Volume 8, Issue 8, August 2011, Pages 532-538
نویسندگان
, , , , , , , , , , , , , , , , , ,