Implementation of emergent MRI for wake-up stroke: a single-center experience
| Autor: | Michael F. Goldberg, Charles Q. Li, Russell Cerejo, Matthew H. Kulzer, Paul Aldinger, Warren Chang, Michael Spearman, Ricardo Ochoa, James Oskin |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Time Factors Neurology medicine.medical_treatment Fluid-attenuated inversion recovery Single Center Brain Ischemia 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Neuroimaging medicine Humans Radiology Nuclear Medicine and imaging In patient cardiovascular diseases Stroke Ischemic Stroke Retrospective Studies Wake up stroke business.industry 030208 emergency & critical care medicine Thrombolysis medicine.disease Magnetic Resonance Imaging Diffusion Magnetic Resonance Imaging Emergency Medicine Radiology business |
| Zdroj: | Emergency Radiology. 28:985-992 |
| ISSN: | 1438-1435 1070-3004 |
| Popis: | Recent updates in national guidelines for management of acute ischemic stroke in patients of unknown time of symptom onset (“wake-up” strokes) incorporate, for the first time, use of emergent MRI. In this retrospective case series, we analyze our experience at a Comprehensive Stroke Center implementing a new workflow including MRI in this clinical setting. This study also describes “DWI-FLAIR” mismatch, a critical concept for the interpretation of emergent brain MRIs performed for wake-up strokes. Over a 14-month period, all brain MRIs for wake-up stroke were identified. The imaging was analyzed by two board-certified, fellowship-trained neuroradiologists, and a diagnosis of DWI-FLAIR mismatch was made by consensus. Process metrics assessed included interval between last known well time and brain imaging, interval between CT and MRI, and interval between brain MRI and interpretation. Sixteen patients with a history of “wake-up stroke” were identified. Thirteen of the 16 patients (81.3%) were found to have a DWI-FLAIR mismatch, suggesting infarct |
| Databáze: | OpenAIRE |
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