针刺疗法作为卒中重要的治疗手段，疗效确切且临床应用广泛，但其在脑保护方面的具体机制尚未完全清晰，这限制了针刺疗法的标准化和推广应用。近年来，神经影像学技术的快速发展为解析针刺促进卒中后脑保护机制提供了新的可视化视角，逐渐揭示其对脑网络、代谢及结构等多维度调控作用。基于多模态神经影像学技术的针刺治疗卒中研究，总结针刺在调节脑代谢、促进白质和灰质结构重塑及优化脑功能重组等方面的重要发现，明确了针刺可通过跨网络调节、代谢调控及结构重塑等机制发挥脑保护作用，并指出当前研究在方法学、技术、机制、转化等方面面临的挑战，并提出未来可能的发展方向，旨在为针刺治疗卒中的现代化应用提供参考。

As a crucial intervention for stroke rehabilitation, acupuncture therapy has demonstrated definite efficacy and been widely used in clinical practice. However, its specific mechanisms in brain protection remain imcompletely elucidated, which limits the standardization and popularization of acupuncture therapy. In recent years, the rapid advancement of neuroimaging technologies has provided a new visualized perspective for deciphering the mechanisms underlying acupuncture-induced post-stroke brain protection, gradually revealing its multi-dimensional regulatory effects on brain networks, metabolism, and structure. Based on studies of acupuncture in stroke using multimodal neuroimaging techniques, this article summarizes key findings regarding acupuncture's roles in regulating cerebral metabolism, promoting structural remodeling of white matter and gray matter, and optimizing cerebral functional reorganization. It clarifies that acupuncture exerts neuroprotective effects through multiple mechanisms such as cross-network regulation, metabolic modulation, and structural remodeling. Additionally,the article points out the challenges faced in current research in terms of methodology, technology, mechanism, and translation, as well as proposes potential future directions. The aim is to provide references for the modern application of acupuncture in stroke treatment.