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Titolo:
Feasibility and practicality of MR imaging of stroke in the management of hyperacute cerebral ischemia
Autore:
Schellinger, PD; Jansen, O; Fiebach, JB; Pohlers, O; Ryssel, H; Heiland, S; Steiner, T; Hacke, W; Sartor, K;
Indirizzi:
Univ Heidelberg, Dept Neurol, Sch Med, D-69120 Heidelberg, Germany Univ Heidelberg Heidelberg Germany D-69120 , D-69120 Heidelberg, Germany Univ Heidelberg, Dept Neuroradiol, Sch Med, D-69120 Heidelberg, Germany Univ Heidelberg Heidelberg Germany D-69120 , D-69120 Heidelberg, Germany
Titolo Testata:
AMERICAN JOURNAL OF NEURORADIOLOGY
fascicolo: 7, volume: 21, anno: 2000,
pagine: 1184 - 1189
SICI:
0195-6108(200008)21:7<1184:FAPOMI>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
DIFFUSION-WEIGHTED MRI; MAGNETIC-RESONANCE; THROMBOLYTIC THERAPY; CONTROLLED TRIAL; LESION VOLUMES; SYMPTOM ONSET; PERFUSION; REPERFUSION; HEMORRHAGE; EVOLUTION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
38
Recensione:
Indirizzi per estratti:
Indirizzo: Schellinger, PD Univ Heidelberg, Dept Neurol, Sch Med, Neuenheimer Feld 400, D-69120 Heidelberg, Germany Univ Heidelberg Neuenheimer Feld 400 Heidelberg Germany D-69120
Citazione:
P.D. Schellinger et al., "Feasibility and practicality of MR imaging of stroke in the management of hyperacute cerebral ischemia", AM J NEUROR, 21(7), 2000, pp. 1184-1189

Abstract

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 gainin 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, less than or equal to3 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 andMR imaging (P < .005), arrival and MR imaging (P < .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 andarrival, 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.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/09/20 alle ore 01:53:49