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Use of DWI-only MR protocol for screening stroke mimics
Roni Eichel1, Tamir Ben Hur, John M Gomori
1Department of Neurology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Journal of the Neurological Sciences
|March 19, 2013
Summary
A diffusion-weighted imaging (DWI)-only MRI protocol effectively distinguishes stroke from stroke mimics. Multiple neurological symptoms significantly increase the likelihood of detecting acute ischemic lesions on DWI scans.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Focal neurological symptoms can indicate stroke or stroke mimics.
- Diffusion-weighted MRI (DWI) is a sensitive tool for detecting acute ischemia.
- Differentiating stroke from mimics is crucial for timely and appropriate patient management.
Purpose of the Study:
- To evaluate the efficacy of a DWI-only MRI protocol in differentiating acute stroke from stroke mimics.
- To assess the diagnostic value of DWI in emergency settings for neurological symptoms.
Main Methods:
- Retrospective analysis of 124 patients with suspected stroke undergoing DWI-only MRI.
- Comparison of patients with positive DWI lesions versus negative DWI findings.
- Analysis of demographic data, risk factors, diagnoses, and patient outcomes.
Main Results:
- DWI MRI identified acute ischemia in 37% of patients.
- Common stroke mimics included peripheral vertigo, confusion, seizures, and migraine with aura.
- Multiple clinical symptoms were a significant predictor of stroke (OR 9.4).
Conclusions:
- A concise DWI-only MRI protocol is effective for differentiating stroke from stroke mimics.
- This protocol can be utilized in emergency departments and for diagnostic purposes.
- The presence of multiple neurological symptoms increases the probability of positive DWI findings for stroke.
