Feasibility and logistics of MRI before thrombolytic treatment

Authors: Sølling, C.1; Ashkanian, M.1; Hjort, N.1; Gyldensted, C.2; Andersen, G.3; Østergaard, L.

Source: Acta Neurologica Scandinavica, Volume 120, Number 3, September 2009 , pp. 143-149(7)

Publisher: Wiley-Blackwell

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Abstract:

Sølling C, Ashkanian M, Hjort N, Gyldensted C, Andersen G, Østergaard L. Feasibility and logistics of MRI before thrombolytic treatment.

Acta Neurol Scand 2009: 120: 143–149.

© 2008 The Authors Journal compilation © 2008 Blackwell Munksgaard. Objectives – 

The study analyzes feasibility and time-delays in Magnetic resonance imaging (MRI) based thrombolysis and estimate the impact of MRI on individual tissue plasminogen activator (rtPA) treatment. Materials and methods – 

Feasibility of MRI and time logistics were prospectively recorded in patients referred with presumed acute stroke over a 2 year time period. Door-to-needle-times (DNT) were compared with those of patients treated with rtPA after conventional CT during the same time period, and to published open label studies. Results – 

We received 174 patients with presumed stroke. MRI was feasible in 141 of 161 (88%) of those requiring acute imaging. MRI supported the decision to treat 11 patients with mild symptoms or seizures, and not to treat four patients with extensive infarctions. Median ‘door-to-needle time’ (DNT) in MR scanned patients (70 min), did not differ significantly from DNT after conventional CT (n = 17, DNT = 66 min, P = 0.27) or the Safe Implementation of Thrombolysis in Stroke (SITS-MOST) registry (DNT = 68 min). Conclusions – 

Magnetic resonance imaging can be performed in the majority of acute stroke patients without delaying treatment. MRI may affect decision making in a large proportion of patients.

Keywords: acute ischemic stroke; acute management of stroke; imaging; magnetic resonance imaging; tissue plasminogen activator

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1600-0404.2008.01136.x

Affiliations: 1: Center of Functionally Integrative Neuroscience (CFIN) Aarhus University Hospital, Århus C, Denmark; 2: Department of Neuroradiology, Aarhus University Hospital, Århus C, Denmark; 3: Department of Neurology, Aarhus University Hospital, Århus C, Denmark

Publication date: September 1, 2009

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