PDF(Pubmed)
Abstract：
Cardioembolic strokes account for 20-25% of all ischaemic strokes, with their incidence increasing with age. Cardiac imaging plays a crucial role in identifying cardioembolic causes of stroke, with early and accurate identification affecting treatment, preventing recurrence, and reducing stroke incidence. Echocardiography serves as the mainstay of cardiac evaluation. Transthoracic echocardiography (TTE) is the first line in the basic evaluation of structural heart disorders, valvular disease, vegetations, and intraventricular thrombus. It can be used to measure chamber size and systolic/diastolic function. Trans-oesophageal echocardiography (TOE) yields better results in identifying potential cardioembolic sources of stroke and should be strongly considered, especially if TTE does not yield adequate results. Cardiac computed tomography and cardiac magnetic resonance imaging provide better soft tissue characterisation, high-grade anatomical information, spatial and temporal visualisation, and image reconstruction in multiple planes, especially with contrast. These techniques are useful in cases of inconclusive echocardiograms and can be used to detect and characterise valvular lesions, thrombi, fibrosis, cardiomyopathies, and aortic plaques. Nuclear imaging is not routinely used, but it can be used to assess left-ventricular perfusion, function, and dimensions and may be useful in cases of infective endocarditis. Its use should be considered on a case-by-case basis. The accuracy of each imaging modality depends on the likely source of cardioembolism, and the choice of imaging approach should be tailored to individual patients.
摘要：
心源性卒中占所有缺血性卒中的20-25%，它们的发病率随着年龄的增长而增加。心脏成像在确定中风的心脏栓塞原因中起着至关重要的作用。早期和准确的识别会影响治疗，防止复发,减少中风的发病率。超声心动图是心脏评估的主要手段。经胸超声心动图(TTE)是心脏结构性疾病基础评价的第一线,瓣膜疾病,植被,和脑室内血栓。它可用于测量腔室大小和收缩/舒张功能。经食道超声心动图（TOE）在确定潜在的心源性栓塞卒中来源方面取得了更好的结果，应加以充分考虑，特别是如果TTE不能产生足够的结果。心脏计算机断层扫描和心脏磁共振成像提供了更好的软组织特征，高级解剖信息，空间和时间可视化，和多个平面中的图像重建，尤其是对比。这些技术在超声心动图不确定的情况下很有用，可用于检测和表征瓣膜病变。血栓,纤维化，心肌病,和主动脉斑块.核成像不是常规使用的，但它可以用来评估左心室灌注，函数,和尺寸，可能对感染性心内膜炎的病例有用。它的使用应根据具体情况加以考虑。每种成像方式的准确性取决于心栓塞的可能来源，成像方法的选择应根据个体患者而定。
