Feasibility of using magnetic resonance imaging as a screening tool for acute stroke thrombolysis
| Autor: | Junya Aoki, Takuya Kanamaru, Hitomi Ozaki, Kazumi Kimura, Kentaro Suzuki, Kanako Muraga, Takehiro Katano, Arata Abe, Satoshi Suda, Midori Tanabe, Kyoko Masuda, Seiji Okubo, Yuki Sakamoto |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Emergency Medical Services Time Factors medicine.medical_treatment Brain Ischemia Time-to-Treatment 03 medical and health sciences 0302 clinical medicine Middle phase Late phase Medicine Humans Screening tool Thrombolytic Therapy 030212 general & internal medicine Prospective Studies Acute stroke Aged Aged 80 and over medicine.diagnostic_test business.industry Brain Magnetic resonance imaging Thrombolysis Limiting Middle Aged Magnetic Resonance Imaging Quality Improvement Surgery Stroke Neurology Feasibility Studies Female Neurology (clinical) Radiology business Early phase Tomography X-Ray Computed 030217 neurology & neurosurgery |
| Zdroj: | Journal of the neurological sciences. 368 |
| ISSN: | 1878-5883 |
| Popis: | Feasibility of performing MRI first for suspected hyperacute stroke patients in real-world practice has not been fully examined. Moreover, most past studies of reducing door-to-needle time (DNT) in intravenous thrombolysis were conducted using CT. The aim of this study was to evaluate the feasibility of an MRI-first policy and examine the effects of a quality improvement (QI) process for reducing DNT using MRI.From January 2014 to August 2015, consecutive acute stroke patients who were treated with thrombolysis were prospectively enrolled into the present study. In principle, multimodal 1.5T-MRI was performed first for patients with suspected acute stroke. A step-by-step QI process for decreasing DNT, including prenotification by the emergency medical service, limiting the MRI sequence, and introduction of a rapid examination tool, was also implemented during this period. Time metrics for thrombolysis were compared between specific time periods.A total of 73 patients (27 women; median age 74years) were included in the present study. More than 80% of the patients were screened with MRI. More patients were managed with the MRI-first policy in the late phase (p=0.018). DNT (83min in the early phase, 68min in the middle phase, and 54min in the late phase, p0.001) was significantly reduced across phases. The percentage of patients with DNT60min increased significantly across time periods (p0.001).An MRI-first policy was feasible, and DNT was substantially reduced with a QI process. This process may be applicable to other hospitals. |
| Databáze: | OpenAIRE |
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