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Related Experiment Video

Updated: Jun 2, 2026

A Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia
09:59

A Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia

Published on: September 16, 2017

MRI guides diagnostic approach for ischaemic stroke.

M A Kumar1, H Vangala, D C Tong

  • 1Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA. monisha.kumar@uphs.upenn.edu

Journal of Neurology, Neurosurgery, and Psychiatry
|May 10, 2011
PubMed
Summary

Diffusion-weighted MRI (DWI) patterns can better predict ischaemic stroke causes than standard methods. An MRI-based approach may reduce the need for echocardiography in about a third of stroke patients.

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Area of Science:

  • Neurology
  • Radiology
  • Cardiology

Background:

  • Accurate identification of ischaemic stroke subtype is crucial for effective treatment.
  • Current diagnostic methods rely on clinical evaluation and various imaging studies.
  • Diffusion-weighted MRI (DWI) patterns offer potential for improved etiological classification.

Purpose of the Study:

  • To evaluate if specific DWI patterns on MRI can reliably guide the diagnostic work-up for acute ischaemic stroke.
  • To compare the effectiveness of MRI-based versus CT-based classification schemas in determining stroke subtypes.
  • To assess the potential of an MRI-based algorithm to streamline diagnostic procedures.

Main Methods:

  • Prospective, observational study of 273 patients with acute ischaemic stroke symptoms.
  • Sequential diagnostic work-up including ECG, CT, MRI, MRA, and transoesophageal echocardiography.
  • Comparison of initial and final TOAST (Trial of Org 10172 in Acute Stroke Treatment) classifications and identification of principal determinants of diagnostic change.

Main Results:

  • DWI patterns were more predictive of stroke aetiologies compared to conventional methods.
  • Transoesophageal echocardiography was a significant determinant of diagnostic change in patients with thromboembolic DWI patterns (8.8%).
  • An MRI-based scheme showed potential to reduce the need for echocardiography and secondary extracranial vascular imaging.

Conclusions:

  • Specific DWI patterns on MRI can accurately predict stroke aetiologies.
  • An MRI-based diagnostic algorithm can potentially obviate the need for echocardiography in one-third of stroke patients.
  • This approach may limit secondary extracranial vascular imaging studies to approximately 10%.