Feasibility and logistics of MRI before thrombolytic treatment
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.
Document Type: Research Article
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