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A Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia
Published on: September 16, 2017
A biochemical marker panel in MRI-proven hyperacute ischemic stroke-a prospective study
Carolin Knauer1, Katharina Knauer, Susanne Müller
1Department of Neurology, University of Ulm, Oberer Eselsberg 45, 89075 Ulm, Germany.
BMC Neurology
|March 10, 2012
Summary
The Triage® Stroke Panel, a multimarker assay, did not reliably diagnose acute ischemic stroke in this study. Researchers do not recommend its use, as it may cause unjustified delays in treatment.
Area of Science:
- Neurology
- Biochemistry
- Medical Diagnostics
Background:
- Computer tomography (CT) is the fastest method to rule out intracranial hemorrhage (ICH) in acute stroke, but its sensitivity for detecting hyperacute ischemic stroke is low.
- Clinical judgment alone is often insufficient due to stroke mimics.
- The Triage® Stroke Panel, a biochemical multimarker assay, was developed to improve the differentiation between ischemic stroke and mimics.
Purpose of the Study:
- To evaluate the diagnostic validity of the Triage® Stroke Panel (MMX index) for identifying ischemic stroke within 6 hours of symptom onset.
- To determine if the panel can expedite the diagnostic pathway for fibrinolysis.
Main Methods:
- 174 consecutive patients admitted to a stroke unit within 6 hours of symptom onset were included.
- Biochemical markers (BNP, DD, MMP-9, S100B) and the resulting MMX index were analyzed.
- Diffusion-weighted MRI (DWI) was used to confirm ischemic strokes, and MMX values were correlated with DWI lesion volume and TOAST criteria.
Main Results:
- No statistically significant difference in MMX values or individual markers was found between ischemic stroke patients and those with stroke mimics.
- The correlation between the MMX index and DWI lesion volume was poor (p = 0.2).
Conclusions:
- The Triage® Stroke Panel (MMX index) demonstrated no diagnostic validity for acute MRI-proven ischemic stroke in this study.
- The assay is not recommended for clinical use due to the potential for unjustified time delays in patient management.
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