Feasibility and logistics of MRI before thrombolytic treatment
June 4th, 2009 Posted by: admin
Sølling C, Ashkanian M, Hjort N, Gyldensted C, Andersen G, Østergaard L. Feasibility and logistics of MRI before thrombolytic treatment.Acta Neurol Scand: DOI: 10.1111/j.1600-0404.2008.01136.x.© 2008 The Authors Journal compilation © 2008 Blackwell Munksgaard.Objectives [ndash] 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 [ndash] 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 [ndash] 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 [ndash] 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.
