Cardiac magnetic resonance imaging: a new tool to identify cardioaortic sources in ischaemic stroke

Area of Science:

• Cardiology
• Neurology
• Radiology

Background:

• Cryptogenic stroke, accounting for 30-40% of ischemic strokes, presents a diagnostic challenge.
• The utility of cardiac imaging in evaluating cryptogenic stroke remains debated.
• Cardiac MRI (CMR) is established for cardiac conditions but its role in cryptogenic stroke is not well-defined.

Purpose of the Study:

• To review the existing literature on the application of Cardiac MRI in the diagnostic evaluation of ischemic stroke patients.
• To assess the potential of CMR in identifying underlying cardiac causes of cryptogenic stroke.
• To explore CMR's role in identifying patients for secondary stroke prevention trials.

Main Methods:

• Literature review encompassing randomized trials, comparative studies, and case series.
• Analysis of studies investigating the use of CMR in patients with ischemic stroke.
• Examination of CMR's ability to detect cardiac thrombi, tumors, aortic arch disease, and other anomalies.

Main Results:

• The body of literature on CMR for ischemic stroke diagnosis is limited.
• Studies suggest CMR can identify potential etiologies in cryptogenic stroke, including cardiac thrombi and tumors.
• CMR provides functional and structural data of the left atrium and appendage, linked to stroke risk.

Conclusions:

• Cardiac MRI is a non-invasive tool with potential for diagnosing cryptogenic stroke mechanisms.
• CMR may help identify patients suitable for clinical trials comparing anticoagulation and antiplatelet therapies.
• Prospective studies are required to compare CMR's diagnostic yield against echocardiography in cryptogenic stroke evaluation.