Stroke, Vol 17, 399-403, Copyright © 1986 by American Heart Association
I Awad, M Modic, JR Little, AJ Furlan and M Weinstein
Twenty-two patients with the clinical diagnosis of transient ischemic
attacks were prospectively evaluated by computed tomography (CT) and proton
magnetic resonance imaging (MRI). Nineteen patients also underwent cerebral
angiography. The MRI studies were performed with a prototype
super-conductive magnet using a 0.6 Tesla or a 1.5 Tesla magnetic field.
Two pulse sequence techniques were used resulting in T1 and T2 weighted
images. All studies were interpreted descriptively by a single
neuroradiologist in a blinded fashion, with special attention to focal
parenchymal abnormalities. Patients with previously documented clinical
strokes or reversible ischemic neurologic deficits lasting more than 24
hours were excluded. The CT scans revealed focal areas of abnormalities in
7 of 22 patients (32%), while the MRI scans showed focal changes in 17
patients (77%). All the CT lesions were clearly visualized on MRI. The MRI
changes were better seen on T2 weighted images as areas of increased signal
intensity. There was a marked preponderance of deep hemispheric lesions on
both CT and MRI studies. Focal parenchymal abnormalities were not limited
to the symptomatic vascular territory. We conclude that MRI reveals focal
parenchymal changes in the majority of patients with transient ischemic
attacks and is more sensitive than late generation CT scans. However,
specificity appears to be poor, and may limit clinical usefulness. While
the significance of the MRI "lesions" remains speculative, they may
represent markers of chronic cerebrovascular disease in these patients.
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Focal parenchymal lesions in transient ischemic attacks: correlation of computed tomography and magnetic resonance imaging
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