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RT Journal Article
SR Electronic
T1 Feasibility and Practicality of MR Imaging of Stroke in the Management of Hyperacute Cerebral Ischemia
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1184
OP 1189
VO 21
IS 7
A1 Schellinger, Peter D
A1 Jansen, Olav
A1 Fiebach, Jochen B
A1 Pohlers, Olivia
A1 Ryssel, Henning
A1 Heiland, Sabine
A1 Steiner, Torsten
A1 Hacke and, Werner
A1 Sartor, Klaus
YR 2000
UL http://www.ajnr.org/content/21/7/1184.abstract
AB BACKGROUND AND PURPOSE: Neuroimaging techniques such as diffusion- and perfusion-weighted MR imaging have been proposed as tools for advanced diagnosis in hyperacute ischemic stroke. There is, however, substantial doubt regarding the feasibility and practicality of applying MR imaging for the diagnosis of stroke on a routine basis, especially with respect to possible delay for specific treatment such as thrombolysis. In this study, we tested whether MR imaging of stroke is safe, fast, and accurate, and whether the gain in additional information can be used in the daily routine without a loss of time and a risk of suboptimal treatment for the patient with stroke.METHODS: Between September 1997 and August 1999, 64 patients with acute ischemic stroke were recruited for MR imaging (ie, diffusion-weighted imaging, perfusion-weighted imaging, MR angiography, T2-weighted imaging) after a baseline CT was performed. We evaluated practicality and feasibility of MR imaging of stroke by analyzing the intervals between symptom onset, arrival, CT, and MR imaging.RESULTS: Sixty-four patients (mean age, 60.9 years) underwent routine CT and MR imaging within 12 hours after stroke onset (n=25, ≤3 hr; n=26, 3–6 hr; n=13, 6–12 hr). Median times to arrival, start of CT, MR imaging, and between CT and MR imaging were 1.625 hours, 2 hours, 3.875 hours, and 1 hour, respectively. Intervals between symptom onset and MR imaging (P&lt;.005), arrival and MR imaging (P&lt;.002), and CT and MR imaging (P=.0007) differed significantly between the early phase of the study and after November 1998, whereas the intervals between symptom onset and arrival, symptom onset and CT, and arrival and CT did not. Hemorrhage could be excluded in all; a perfusion/diffusion match or mismatch could be shown in 63 of 64 patients.CONCLUSION: Practice and experience with MR imaging in a stroke team significantly reduce the time and effort required to perform this technique and thus make 24-hour availability for MR imaging of stroke practical. Assessment of patients with hyperacute stroke is rapid and comprehensive. Image quality can be substantially improved by head immobilization and by mild sedation, if necessary.