ssmuБюллетень сибирской медициныBulletin of Siberian Medicine1682-03631819-3684Siberian State Medical University, the Ministry of Healthcare of the Russian Federation10.20538/1682-0363-2026-2-150-160ssmu-6544Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEW AND LECTURESМультимодальная магнитно-резонансная томография головного мозга в оценке реабилитационного потенциала у пациентов после перенесенного ишемического инсультаMultimodal magnetic resonance imaging of the brain at different stages of rehabilitation after ischemic strokehttps://orcid.org/0000-0003-1316-5421КуражовА. П.KurazhovA. P.

Куражов Алексей Петрович – врач-рентгенолог, д-р мед. наук, профессор кафедры лучевой диагностики и лучевой терапии

Россия, 634050, г. Томск, Московский тракт, 2

2 Moscovsky trakt, 634050 Tomsk, Russian Federation

kurazhovap@mail.ruhttps://orcid.org/0000-0002-4140-3223АлифироваВ. М.AlifirovaV. M.

Алифирова Валентина Михайловна – врач-невролог, д-р мед. наук, профессор, зав. кафедрой неврологии и нейрохирургии

Россия, 634050, г. Томск, Московский тракт, 2

2 Moscovsky trakt, 634050 Tomsk, Russian Federation

v_alifirova@mail.ruhttps://orcid.org/0000-0003-1911-166XКоролёваЕ. С.KorolevaE. S.

Королёва Екатерина Сергеевна – врач-невролог, д-р мед. наук, профессор кафедры неврологии и нейрохирургии

Россия, 634050, г. Томск, Московский тракт, 2

2 Moscovsky trakt, 634050 Tomsk, Russian Federation

kattorina@list.ruhttps://orcid.org/0000-0002-8812-4168ДегтяревИ. Ю.DegtyarevI. Yu.

Дегтярев Илья Юрьевич – врач-рентгенолог, аспирант, кафедра лучевой диагностики и лучевой терапии

Россия, 634050, г. Томск, Московский тракт, 2

2 Moscovsky trakt, 634050 Tomsk, Russian Federation

ilya.degtyarev.4201@mail.ruhttps://orcid.org/0000-0002-1889-4554ЛойкоЮ. Н.LoikoYu. N.

Лойко Юлия Николаевна – врач-рентгенолог

Россия, 634063, г. Томск, ул. Мичурина, 105

105 Michurin St., 634063 Tomsk, Russian Federation

loikojulian@gmail.comhttps://orcid.org/0000-0003-4968-4012КучероваК. С.KucherovaK. S.

Кучерова Кристина Сергеевна – врач-невролог, ассистент кафедры неврологии и нейрохирургии 

Россия, 634050, г. Томск, Московский тракт, 2

2 Moscovsky trakt, 634050 Tomsk, Russian Federation

kristyajka@ya.ruhttps://orcid.org/0000-0001-9449-8564СухановаК. С.SukhanovaK. S.

Суханова Кристина Сергеевна – врач-рентгенолог, отделение компьютерной томографии, клиники 

Россия, 634050, г. Томск, Московский тракт, 2

2 Moscovsky trakt, 634050 Tomsk, Russian Federation

athos227930@gmail.comhttps://orcid.org/0000-0001-6231-7650ЗавадовскаяВ. Д.ZavadovskayaV. D.

Завадовская Вера Дмитриевна – врач-рентгенолог, д-р мед. наук, профессор, зав. кафедрой лучевой диагностики и лучевой терапии

Россия, 634050, г. Томск, Московский тракт, 2

2 Moscovsky trakt, 634050 Tomsk, Russian Federation

wdzav@mail.ruСибирский государственный медицинский университет (СибГМУ)РоссияSiberian State Medical UniversityRussian FederationЛечебно-диагностический центр (ЛДЦ) Медицинского института им. Березина Сергея (МИБС)РоссияTreatment and Diagnostic Center, Dr. Berezin Medical InstituteRussian Federation202623072026252150160Copyright © Куражов А.П., Алифирова В.М., Королёва Е.С., Дегтярев И.Ю., Лойко Ю.Н., Кучерова К.С., Суханова К.С., Завадовская В.Д., 20262026Куражов А.П., Алифирова В.М., Королёва Е.С., Дегтярев И.Ю., Лойко Ю.Н., Кучерова К.С., Суханова К.С., Завадовская В.Д.Kurazhov A.P., Alifirova V.M., Koroleva E.S., Degtyarev I.Y., Loiko Y.N., Kucherova K.S., Sukhanova K.S., Zavadovskaya V.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://bulletin.ssmu.ru/jour/article/view/6544

Острые нарушения мозгового кровообращения являются важной медико-социальной проблемой как в мире, так и в Российской Федерации, что обусловлено высокими показателями заболеваемости, смертности и инвалидизации. Основу разработки инновационных подходов ускоренной реабилитации лиц после перенесенного ишемического инсульта составляет исследование нейропластичности с использованием методов современной нейровизуализации, таких как мультимодальная магнитно-резонансная томография (МРТ).Представлен обзор литературы, в котором рассматриваются диагностические возможности различных компонентов мультипараметрической МРТ, таких как функциональная МРТ, ASL-МРТ и диффузионно-тензорная МРТ, включая их потенциальные преимущества и недостатки применительно к оценке реабилитационного потенциала у пациентов после перенесенного ишемического инсульта. Показано, что данные компоненты мультипараметрической МРТ могут быть успешно использованы для изучения механизмов нейропластичности и определения ответа на терапию в ходе реабилитационных мероприятий у пациентов после ишемического инсульта. Обозначены проблемные аспекты активного внедрения мультипараметрической МРТ в широкую клиническую практику, главными из которых являются отсутствие глубоких знаний о диагностических возможностях того или иного компонента данной технологии в конкретной клинической ситуации, сложность ее использования и недостаточная емкость доказательной научной базы.

Stroke is an important medical and social problem in the world and in the Russian Federation, which is due to high rates of morbidity, mortality, and disability. The basis for the development of innovative approaches to the accelerated rehabilitation of individuals after an ischemic stroke is the study of neuroplasticity using modern neuroimaging methods, such as multimodal magnetic resonance imaging (MRI).The present literature review describes diagnostic capabilities of different multimodal MRI modalities, such as functional MRI (fMRI), ASL MR perfusion, and diffusion tensor MRI, including their advantages and drawbacks in assessing rehabilitation potential of patients after ischemic stroke. These MRI modalities can be successfully utilized to study the mechanisms of neuroplasticity and identify reliable markers of a response to therapy in context of rehabilitation measures in stroke patients.It was shown that broad implementation of multimodal MRI in clinical practice is hindered by a lack of profound knowledge about its diagnostic capabilities in certain clinical settings, complexity of its use, and insufficient evidence base.

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The authors declare that there are no conflicts of interest present.