Imaging research, diagnosis, and treatment advances of post-stroke cognitive impairment.

Post-stroke cognitive impairment (PSCI) has garnered widespread attention due to its high incidence and its association with increased risk of stroke recurrence and mortality. Growing evidence indicates that early prediction of PSCI and the implementation of effective interventions can help delay disease progression and improve long-term patient outcomes. With advances in imaging technology, the role of neuroimaging has evolved from traditional anatomical localization to a multimodal assessment system that integrates macrostructural, microstructural connectivity, and molecular metabolic information. Imaging features can serve as objective and reproducible quantitative indicators, sensitively capturing subtle pathological changes in brain tissue, thereby providing a reliable basis for clinical diagnosis, treatment strategy formulation, and prevention. This review systematically summarizes recent research progress in the clinical diagnosis and imaging characteristics of PSCI. It focuses on analyzing the impact and underlying mechanisms of specific biomarkers, gene expression, cerebral small vessel disease, and cerebral perfusion abnormalities on cognitive function, and further explores the application prospects of advanced imaging technologies in the assessment of PSCI.