Evaluating cardiac sources of embolic stroke with MRI

Area of Science:

• Cardiology
• Neurology
• Radiology

Background:

• Stroke evaluation requires identifying etiology for tailored therapy.
• Current diagnostics include brain, head/neck artery, aorta, and heart imaging.
• Traditional cardiac imaging includes echocardiography (TTE/TEE).

Purpose of the Study:

• To review the advantages and limitations of echocardiography and cardiac magnetic resonance (CMR) imaging.
• To compare these modalities in diagnosing cardioembolic stroke.
• To discuss their current clinical practice roles.

Main Methods:

• Review of echocardiography (TTE/TEE) and cardiac magnetic resonance (CMR) imaging.
• Focus on diagnosing common cardioembolic stroke etiologies.
• Comparison of diagnostic capabilities.

Main Results:

• Echocardiography is a cornerstone of cardiac imaging.
• CMR increasingly assesses key cardioembolic stroke sources: left atrial/appendage thrombus, left ventricular thrombus, aortic atheroma, cardiac masses, and patent foramen ovale.
• Both modalities have distinct advantages and limitations.

Conclusions:

• Both echocardiography and CMR are vital in evaluating patients with suspected embolic stroke.
• The choice of imaging modality depends on specific clinical scenarios and suspected etiologies.
• Further understanding of their roles aids in optimizing patient management.