ReviewNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2025
Current state and advancements of imaging in acute ischemic stroke: a practical review.
Review in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Clinical Utility of Circulating Biomarkers for Diagnosis and Prognosis of Acute Stroke in the Emergency Department: A Narrative Review from Current Evidence to Clinical Implementation.Diagnostics (Basel, Switzerland) · 2026Review
- Anatomy- and Time-Based Post-Processing with CT Perfusion-Derived Time-Vessel Maps to Reduce Incorrect Occlusion Detections in Late-Phase CT Angiography.Diagnostics (Basel, Switzerland) · 2026Article
- AGTS-Net: Anatomically Guided Two-Stage Network for Actionable Stroke Classification in Complete NCCT Studies.Bioengineering (Basel, Switzerland) · 2026Article
- Focused Ultrasound Modulation of PGC-1α Pathways in Neurological Disease: Mechanistic Rationale and Translational Opportunities.Molecular neurobiology · 2026Review
- The Impact of Emergency Department Process Optimization Combined With Health Education on the Treatment Outcomes and Anxiety and Depression in Patients With Acute Ischemic Stroke.Actas espanolas de psiquiatria · 2026Article
- Role of diffusion weighted imaging, apparent diffusion coefficient and magnetic resonence perfusion among acute ischemic stroke patient.Bioinformation · 2026Article
- Multiple sclerosis as an under-recognized cause of acute vertigo: clinical and pathophysiologic insights.Frontiers in neurology · 2026Review
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNeuroimaging has a pivotal role in the diagnosis, management, and prognostication of acute ischemic stroke (AIS). Developments have improved the ability to identify large vessel occlusions (LVO), delineate salvageable tissue, and guide acute therapeutic interventions. This review aimed to provide an overview of neuroimaging modalities used in AIS evaluation, highlighting their practical applications, recent advancements, and limitations.
methodsWe conducted a narrative review of the literature, focusing on non-contrast CT (NCCT), CT angiography (CTA), CT perfusion (CTP), MRI, MR angiography (MRA), digital subtraction angiography (DSA), and transcranial Doppler ultrasonography (TCD). Additionally, we examined emerging trends, such as virtual NCCT, sonothrombolysis and direct-to-angio suite (DTAS) approach. Key aspects, including diagnostic accuracy, clinical utility, and emerging technologies were evaluated.
findingsNCCT remains the cornerstone for initial AIS assessment due to its availability and its ability to assist in rapid decision making. CTA and CTP are integral for detecting LVO and assessing penumbra, respectively, with automated systems enhancing speed and accuracy. MRI helps identify early ischemic changes and rule out stroke mimics. MRA and DSA provide detailed vascular assessments, while TCD offers hemodynamic monitoring and a potential therapeutic role. Limitations include variability in perfusion imaging, MRI availability, and operator dependency in TCD. Emerging techniques like dual-energy CT and AI-driven algorithms enhance diagnostic precision.
conclusionNeuroimaging is essential for effective AIS management, with each modality carrying variable strengths and limitations. Continued advancements, standardization and a multi-modal approach are needed to optimize outcomes. Clinical-radiological correlation remains indispensable to reach accurate diagnosis and treatment.
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