Utility of T2* Gradient-Echo Magnetic Resonance Imaging in Routine Imaging of Ischemic Stroke
Objective: To determine the utility of routine T2* weighted gradient-echo magnetic resonance imaging (MRI) in evaluating patients with ischemic stroke. Methods: One hundred stroke patients with CT scans negative for hemorrhage were prospectively evaluated with T1, T2, FLAIR, and T2* weighted gradient-echo imaging. Results: Ten T2* scans showed evidence of prior hemorrhage, 9 asymptomatic. Seven had abnormalities seen only on T2* imaging. Three had evidence of blood products on T2 as well as T2* (1 subacute). In one patient, a T2* done 2 hours after giving tPA showed abnormality consistent with amyloid angiopathy. She had a subsequent hemorrhagic complication. Discussion: Ten percent of our patients with negative CT scans showed evidence of prior hemorrhage on MRI. Seven percent showed abnormality consistent with hemorrhage only on T2* imaging. T2* sequences are rapidly obtained and readily available on most existing scanners with no additional hardware or software requirements. The information obtained may not be available clinically or with other imaging studies and may alter both acute and chronic management decisions. Conclusion: While our sample size is small, our data indicate that T2* gradient-echo MRI may a valuable tool in the routine imaging evaluation of ischemic stroke.