Advances in Stroke

Over the past 2 years, there have been substantial advances in many areas of stroke imaging; in this review, due to space limitations, we highlight major themes with a focus on acute stroke as well as vessel imaging. We recognize that there has been a much larger body of important work including imaging in animal models, stroke recovery, and cognitive impairment that we anticipate is covered in other sections.In acute ischemic stroke, there continues to be steady progress toward identifying the best imaging profiles that can be used to select patients for therapies and/or predict outcomes. Several studies have continued to highlight the need for greater consistency and standardized approaches in identifying perfusion thresholds for tissue viability with both CT and MRI.1,2 Real-time analyses for postprocessing of multimodal imaging data show promise and feasibility,3 but also potential pitfalls, including overestimation of perfusion deficits.4Secondary analyses from the Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET) and Diffusion and Perfusion Imaging Evaluation for Understanding Stroke Evolution (DEFUSE) studies have underscored the importance of absolute volumes of baseline perfusion and diffusion deficits (as opposed to the mismatch profile) in predicting outcome and response to therapy.5 The optimal definition of the malignant profile (time to …