Abstract WP40: CT-based Evaluation is Faster and as Precise as MRI in Acute Stroke Evaluation
Introduction: The issue if Computer Tomography (CT) or Magnetic Resonance Imaging (MRI) are ‘best’ in evaluation of patients with symptoms of acute stroke prior to intravenous-tissue-plasminogen-activator treatment (iv-tPA) has been widely discussed; CT-based door-to-needle-times of 20 minutes are feasible and motivated by time-dependent efficacy of iv-tPA, but the more time consuming MRI-based evaluation likely provides additional information on hyper-acute cerebral ischemia and iv-tPA-contraindicating stroke mimicking pathology.
Aim: The aim of this study was to compare the delay of iv-tPA-treatment and the level of diagnostic information obtained for patients randomized to CT and MRI-based acute stroke evaluation.
Method: Three-hundred-sixty-nine consecutive patients admitted with symptoms of stroke within 4.5 hours from symptom-onset were quasi-randomized to CT or MRI-based evaluation as part of an ongoing single-center trial and treated with iv-tPA if eligible.
Door-to-needle-times for patients, allocated to CT and MRI, were compared. Imaging of diagnostic quality and stroke mimicking detected pathology were registered for the two modalities.
Results: Door-to-needle-times for CT evaluated patients (median 26 (7-55) min) were significantly faster than for MRI-examined patients (median 36 (11-71) min), p=0.007.
Imaging of adequate diagnostic quality was acquired for all patients examined with CT and for 96.4% of patients, without inherent MRI-contraindications, examined with MRI.
All patients with discharge diagnoses of intracerebral hemorrhage and intracerebral oncological pathology were identified by the primary scan at admission, regardless if CT or MRI were performed.
Conclusion: CT-based evaluation prior to iv-tPA-treatment is faster and as presice as MRI-based evaluation of patients with acute stroke.
Author Disclosures: C.K. Hansen: Research Grant; Modest; The Danish Tryg Foundation. A. Christensen: None. I. Havsteen: None. H. Christensen: None.
- © 2016 by American Heart Association, Inc.