PERFUSIÓN POR TOMOGRAFÍA COMPUTARIZADA VERSUS RESONANCIA DIFUSIÓN-PERFUSIÓN EN ICTUS ISQUÉMICO TARDÍO
Palabras clave:
Accidente cerebrovascular isquémico, Perfusión por tomografía computarizada, Imagen por resonancia magnética, TrombectomíaResumen
DOI: https://doi.org/10.46296/yc.v10i18.0855
Resumen
La neuroimagen avanzada amplió la selección de pacientes con ictus isquémico y oclusión de gran vaso más allá de las primeras seis horas. Esta revisión de tema comparó la perfusión por tomografía computarizada y la resonancia magnética con difusión y perfusión para la toma de decisiones entre seis y veinticuatro horas. Se revisaron PubMed, Scopus y Embase entre 2016 y 2025. Ambos métodos identifican núcleo isquémico y tejido recuperable con resultados clínicos semejantes cuando se aplican criterios validados. La perfusión por tomografía computarizada ofrece mayor disponibilidad, integración al flujo del código ictus y menor impacto logístico. La resonancia magnética con difusión y perfusión aporta mejor caracterización tisular y mayor capacidad para excluir imitadores, aunque con menor acceso y más contraindicaciones. La variabilidad entre programas de posprocesamiento y la heterogeneidad operativa siguen limitando la estandarización. En conclusión, ambas estrategias son válidas; la elección debe individualizarse según recursos, tiempos y contexto clínico.
Palabras claves: Accidente cerebrovascular isquémico, Perfusión por tomografía computarizada, Imagen por resonancia magnética, Trombectomía.
Abstract
Advanced neuroimaging expanded patient selection for acute ischemic stroke with large vessel occlusion beyond the first six hours. This review compared computed tomography perfusion and magnetic resonance imaging with diffusion and perfusion for decision making between six and twenty-four hours. PubMed, Scopus, and Embase were reviewed from 2016 to 2025. Both methods identify infarct core and potentially salvageable tissue with similar clinical results when validated criteria are applied. Computed tomography perfusion offers broader availability, easier integration into stroke workflow, and less logistical burden. Magnetic resonance imaging with diffusion and perfusion provides better tissue characterization and stronger exclusion of stroke mimics, although with lower access and more contraindications. Postprocessing software variability and operational heterogeneity still limit standardization. Overall, both strategies are valid, and the choice should be individualized according to resources, timing, and clinical context.
Keywords: Ischemic stroke, Computed tomography perfusion, Magnetic resonance imaging, Thrombectomy.
Información del manuscrito:
Fecha de recepción: 08 de enero de 2026.
Fecha de aceptación: 20 de marzo de 2026.
Fecha de publicación: 20 de abril de 2026.
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