Feasibility and Practicality of MR Imaging of Stroke in the Management of Hyperacute Cerebral Ischemia

• Published in: American journal of neuroradiology : AJNR 2000-08, Vol.21 (7), p.1184-1189
• Main Authors: Schellinger, Peter D, Jansen, Olav, Fiebach, Jochen B, Pohlers, Olivia, Ryssel, Henning, Heiland, Sabine, Steiner, Torsten, Hacke and, Werner, Sartor, Klaus
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Brain; Cerebral Infarction - diagnosis; Cerebral Infarction - drug therapy; Cerebral Infarction - mortality; Diffusion; Echo-Planar Imaging; Feasibility Studies; Female; Humans; Image Enhancement; Investigative techniques, diagnostic techniques (general aspects); Magnetic Resonance Angiography - methods; Magnetic Resonance Imaging - methods; Male; Medical sciences; Middle Aged; Nervous system; Neurology; Predictive Value of Tests; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Survival Rate; Thrombolytic Therapy; Time and Motion Studies; Tomography, X-Ray Computed; Vascular diseases and vascular malformations of the nervous system
• ISSN: 0195-6108; 1936-959X

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. 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. Sixty-four patients (mean age, 60.9 years) underwent routine CT and MR imaging within 12 hours after stroke onset (n=25, < or =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