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J Stroke. 2016 Sep;18(3):286-296. English. Review.
Kim J , Park JE , Nahrendorf M , Kim DE .
Molecular Imaging and Neurovascular Research (MINER) Laboratory, Dongguk University Ilsan Hospital, Goyang, Korea.
Global Research Laboratory for Thrombus-targeted Theranostics at Dongguk University Ilsan Hospital (Korea) and Massachusetts General Hospital (USA).
Department of Neurology, Dongguk University Ilsan Hospital, Goyang, Korea.
Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.

There is an emergent need for imaging methods to better triage patients with acute stroke for tissue-plasminogen activator (tPA)-mediated thrombolysis or endovascular clot retrieval by directly visualizing the size and distribution of cerebral thromboemboli. Currently, magnetic resonance (MR) or computed tomography (CT) angiography visualizes the obstruction of blood flow within the vessel lumen rather than the thrombus itself. The present visualization method, which relies on observation of the dense artery sign (the appearance of cerebral thrombi on a non-enhanced CT), suffers from low sensitivity. When translated into the clinical setting, direct thrombus imaging is likely to enable individualized acute stroke therapy by allowing clinicians to detect the thrombus with high sensitivity, assess the size and nature of the thrombus more precisely, serially monitor the therapeutic effects of thrombolysis, and detect post-treatment recurrence. This review is intended to provide recent updates on stroke-related direct thrombus imaging using MR imaging, positron emission tomography, or CT.

Copyright © 2019. Korean Association of Medical Journal Editors.