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Updated: Sep 12, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
The comparison of MRI and CT protocol examination times for mechanical thrombectomy in acute ischemic stroke
Akai Tsuda1, Daisuke Oura2,3, Riku Ihara1
1Department of Radiology, Otaru General Hospital, 1-1-1 Wakamatsu, Otaru, Hokkaido, 047-8550, Japan.
Abstract:
In acute ischemic stroke (AIS), where the shortest possible assessment is required to minimize time to mechanical thrombectomy (MT). With recent advancements in MRI reconstruction technology, MRI has also become valuable in the decision-making process for AIS treatment planning. In this study, we compared the examination times of our MRI protocol with those of a standard CT protocol for evaluating AIS through phantom simulations to obtain timing information directly relevant to treatment strategies, and evaluated the utility of MRI for MT. Ten radiological technologists performed scans using the same phantom for each modality. Evaluation items included time for hemorrhage detection, time for penumbra evaluation, and time for brain artery evaluation, and total examination time. The total examination time was slightly shorter with CT (696.2 ± 52.7 s) compared to MRI (701.8 ± 15.8 s), although this difference was not statistically significant (p = 0.4). For other parameters, MRI demonstrated significantly faster detection times: hemorrhage detection (CT, 80.9 ± 12.8 s; MRI, 66.3 ± 1.7 s; p = 0.0002), penumbra evaluation (CT, 696.2 ± 52.7 s; MRI, 262.1 ± 9.3 s; p = 0.0002), and brain artery evaluation (CT, 592.1 ± 32.3 s; MRI, 367.8 ± 8.3 s; p = 0.0002). The coefficient of variation (CV) was lower for MRI compared to CT, indicating less variability in examination times with MRI. This study demonstrates that MRI protocols, including perfusion imaging, can more rapidly visualize factors essential for MT decision-making and do not delay time to MT.
Insights
Magnetic Resonance Imaging (MRI) offers faster evaluation for acute ischemic stroke (AIS) treatment planning compared to CT scans. Advanced MRI protocols can expedite mechanical thrombectomy (MT) decisions without increasing overall assessment time.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Acute ischemic stroke (AIS) requires rapid assessment for effective mechanical thrombectomy (MT).
- Magnetic Resonance Imaging (MRI) advancements enhance its role in AIS treatment planning.
- Evaluating the time efficiency of MRI versus CT for AIS is crucial for optimizing MT workflows.
Purpose of the Study:
- To compare the examination times of a specific MRI protocol against a standard CT protocol for AIS evaluation.
- To assess the utility of MRI in the context of time-sensitive MT decision-making.
- To analyze specific evaluation times including hemorrhage, penumbra, and brain artery assessment.
Main Methods:
- Phantom simulations were used to directly measure examination times for both MRI and CT protocols.
- Ten radiological technologists performed scans on identical phantoms for each imaging modality.
- Key evaluation metrics included hemorrhage detection time, penumbra evaluation time, brain artery evaluation time, and total examination time.
Main Results:
- Total examination time was comparable between CT (696.2 ± 52.7 s) and MRI (701.8 ± 15.8 s), with no statistical significance (p=0.4).
- MRI showed significantly faster detection times for hemorrhage (66.3 ± 1.7 s vs. 80.9 ± 12.8 s), penumbra evaluation (262.1 ± 9.3 s vs. 696.2 ± 52.7 s), and brain artery evaluation (367.8 ± 8.3 s vs. 592.1 ± 32.3 s).
- MRI exhibited a lower coefficient of variation (CV) than CT, indicating more consistent examination times.
Conclusions:
- MRI protocols, including perfusion imaging, can rapidly visualize critical factors for MT decision-making.
- The use of MRI for AIS evaluation does not introduce delays in the time to mechanical thrombectomy.
- MRI is a viable and efficient imaging modality for acute ischemic stroke treatment planning and MT.
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Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...