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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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CT Perfusion Protocol for Acute Stroke Expedites Mechanical Thrombectomy.

Matthew Jenson1, Jeremiah Libby1, Erik Soule2

  • 1Radiology, University of Florida College of Medicine, Jacksonville, USA.

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PubMed
Summary

Replacing MRI with CT perfusion significantly reduced stroke imaging time by 49%, from 158 to 81 minutes. This expedited workflow may improve outcomes for acute stroke patients.

Keywords:
computed tomography perfusionendovascular revascularizationmagnetic resonance imagingmechanical thrombectomystroke

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Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • Acute cerebrovascular accident (stroke) evaluation requires timely diagnosis and treatment.
  • Current protocols often involve computed tomography (CT), computed tomography angiogram (CTA), and magnetic resonance imaging (MRI) with hyperacute stroke protocols.
  • Delays in diagnosis and treatment negatively impact neurological outcomes.

Purpose of the Study:

  • To compare the "stroke imaging time" between MRI and CT perfusion protocols for acute stroke workup.
  • To determine if replacing MRI with CT perfusion expedites intra-arterial intervention.

Main Methods:

  • Retrospective analysis of stroke imaging protocols.
  • Measurement of "stroke imaging time" for both MRI-based and CT perfusion-based protocols.
  • Comparison of average imaging times between the two protocols.

Main Results:

  • Average stroke imaging time decreased from 158 minutes with MRI to 81 minutes with CT perfusion.
  • This represents a 49% reduction in imaging time.
  • CT perfusion protocols may expedite the diagnostic and treatment workflow.

Conclusions:

  • Substituting CT perfusion for MRI in hyperacute stroke protocols significantly reduces "stroke imaging time".
  • This expedited imaging workflow has the potential to accelerate intra-arterial interventions.
  • Faster intervention in acute ischemic stroke can lead to improved patient outcomes.