scholarly journals The computer and magnetic resonance imaging in the early assessment of the clinical course of ischemic stroke

2019 ◽  
Vol 18 (2) ◽  
pp. 35-40
Author(s):  
R. Kh. Aldatov ◽  
V. A. Fokin
Keyword(s):  
Magnetic Resonance Imaging ◽  
Ischemic Stroke ◽  
Magnetic Resonance ◽  
Intravenous Thrombolysis ◽  
Neurological Symptoms ◽  
Limiting Factor ◽  
Resonance Imaging ◽  
Early Assessment ◽  
Stage Of Development ◽  
The Moment

The most important benefit that imaging provides to a patient with ischemic stroke is the rapid identification of those patients who are most likely to benefit from emergency treatment. This group includes patients who suffer from severe neurological symptoms due to the occlusion of the main artery, and those who are candidates for recanalization by intravenous thrombolysis or intra-arterial intervention to remove blockage.Objective – to assess the sensitivity and significance of computed tomography and magnetic resonance imaging in early diagnosis of infarction foci.Material and methods. The results of radiologic studies of 89 patients with a clinical picture, suspected of acute ischemic cerebral circulation disorders, received in the first 24 hours from the moment of development of neurological symptoms were analyzed.Results. As a result of our study, it was shown that in the first group of patients received in the first 4.5 h from the moment of development of neurological symptoms of CT-signs of stroke were not detected in 16 (76 %) of 21 patients, while those received in the first 24 h from the moment of development of neurological symptoms of CT-signs of stroke were not detected in 14 (28 %) of 50 patients, determined by the symptom of strengthening of the artery, loss of differentiation between gray and white matter of the brain, smoothness of cortical furrows and the appearance of a zone of reduced densitometric density brain substances (<22HU). The difficulties of diagnosis in some patients on CT were the size and localization of ischemic areas (lacunar, stem strokes). In group II of 18 patients of the study, native MRI revealed signs of ischemic areas in 10 patients out of 10, complex CT and MRI to determined areas of hypoperfusion in 8 patients out of 8.Conclusion. CT is the most widely used imaging technique for cerebral infarction with high sensitivity to intracerebral hemorrhage, high specificity in ischemia, but low sensitivity to the detection of ischemic changes is a limiting factor. The data obtained confirm that MRI is a reliable method of diagnosing ischemic stroke. The most sensitive in the diagnosis of ischemic changes in the acute stage of development by using DWI (b1000).

Extending the time window for intravenous thrombolysis in acute ischemic stroke using magnetic resonance imaging-based patient selection

2019 ◽  
Vol 14 (5) ◽  
pp. 483-490 ◽  
Author(s):  
Peter Ringleb ◽  
Martin Bendszus ◽  
Erich Bluhmki ◽  
Geoffrey Donnan ◽  
Christoph Eschenfelder ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Ischemic Stroke ◽  
Magnetic Resonance ◽  
Acute Ischemic Stroke ◽  
Time Window ◽  
Intravenous Thrombolysis ◽  
Modified Rankin Scale ◽  
Resonance Imaging ◽  
Stroke Patients ◽  
Symptomatic Intracranial Hemorrhage

Background Intravenous thrombolysis with alteplase within a time window up to 4.5 h is the only approved pharmacological treatment for acute ischemic stroke. We studied whether acute ischemic stroke patients with penumbral tissue identified on magnetic resonance imaging 4.5–9 h after symptom onset benefit from intravenous thrombolysis compared to placebo. Methods Acute ischemic stroke patients with salvageable brain tissue identified on a magnetic resonance imaging were randomly assigned to receive standard dose alteplase or placebo. The primary end point was disability at 90 days assessed by the modified Rankin scale, which has a range of 0–6 (with 0 indicating no symptoms at all and 6 indicating death). Safety end points included death, symptomatic intracranial hemorrhage, and other serious adverse events. Results The trial was stopped early for slow recruitment after the enrollment of 119 (61 alteplase, 58 placebo) of 264 patients planned. Median time to intravenous thrombolysis was 7 h 42 min. The primary endpoint showed no significant difference in the modified Rankin scale distribution at day 90 (odds ratio alteplase versus placebo, 1.20; 95% CI, 0.63–2.27, P = 0.58). One symptomatic intracranial hemorrhage occurred in the alteplase group. Mortality at 90 days did not differ significantly between the two groups (11.5 and 6.8%, respectively; P = 0.53). Conclusions Intravenous alteplase administered between 4.5 and 9 h after the onset of symptoms in patients with salvageable tissue did not result in a significant benefit over placebo. (Supported by Boehringer Ingelheim, Germany; ISRCTN 71616222).

scholarly journals Diagnosis of Acute Ischemic Stroke Based on Time-To-Peak and Diffusion-Weighted Magnetic Resonance Imaging.

2002 ◽  
Vol 42 (7) ◽  
pp. 281-288
Author(s):  
Keisuke MARUYAMA ◽  
Tsuneyoshi EGUCHI ◽  
Shigeo SORA ◽  
Masafumi IZUMI ◽  
Hirofumi HIYAMA ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Ischemic Stroke ◽  
Magnetic Resonance ◽  
Acute Ischemic Stroke ◽  
Resonance Imaging ◽  
Time To Peak ◽  
Diffusion Weighted ◽  
Weighted Magnetic Resonance Imaging ◽  
And Diffusion

scholarly journals Predictors of Spondylolysis on Magnetic Resonance Imaging in Adolescent Athletes With Low Back Pain

2021 ◽  
Vol 9 (4) ◽  
pp. 232596712199546
Author(s):  
Takuji Yokoe ◽  
Takuya Tajima ◽  
Hiroshi Sugimura ◽  
Shinichirou Kubo ◽  
Shotarou Nozaki ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Low Back Pain ◽  
Back Pain ◽  
Magnetic Resonance ◽  
Neurological Symptoms ◽  
Low Back ◽  
Resonance Imaging ◽  
Advanced Imaging ◽  
Adolescent Athletes ◽  
Mri Scans

Background: Spondylolysis and undiagnosed mechanical low back pain (UMLBP) are the main causes of low back pain (LBP) in adolescent athletes. No studies have evaluated the difference in clinical and radiographic factors between these 2 conditions. Furthermore, it remains unclear which adolescent athletes with LBP should undergo advanced imaging examination for spondylolysis. Purpose: To compare the clinical and radiographic factors of adolescent athletes with spondylolysis and UMLBP who did not have neurological symptoms or findings before magnetic resonance imaging (MRI) evaluation and to determine the predictors of spondylolysis findings on MRI. Study Design: Cohort study, Level of evidence, 3. Methods: The study population included 122 adolescent athletes aged 11 to 18 years who had LBP without neurological symptoms or findings and who underwent MRI. Of these participants, 75 were ultimately diagnosed with spondylolysis, and 47 were diagnosed with UMLBP. Clinical factors and the following radiographic parameters were compared between the 2 groups: spina bifida occulta, lumbar lordosis (LL) angle, and the ratio of the interfacet distance of L1 to that of L5 (L1:L5 ratio, %). A logistic regression analysis was performed to evaluate independent predictors of spondylolysis on MRI scans. Results: Significantly more athletes with spondylolysis were male (82.7% vs 48.9%; P < .001), had a greater LL angle (22.8° ± 8.1° vs 19.3° ± 8.5°; P = .02), and had a higher L1:L5 ratio (67.4% ± 6.3% vs 63.4% ± 6.6%; P = .001) versus athletes with UMLBP. A multivariate analysis revealed that male sex (odds ratio [OR], 4.66; P < .001) and an L1:L5 ratio of >65% (OR, 3.48; P = .003) were independent predictors of positive findings of spondylolysis on MRI scans. Conclusion: The study findings indicated that sex and the L1:L5 ratio are important indicators for whether to perform MRI as an advanced imaging examination for adolescent athletes with LBP who have no neurological symptoms and findings.

scholarly journals Magnetic resonance imaging in brainstem ischemic stroke

1991 ◽  
Vol 6 (4) ◽  
pp. 355 ◽  
Author(s):  
Jae Kyu Roh ◽  
Kwang Kuk Kim ◽  
Moon Hee Han ◽  
Kee Hyun Chang ◽  
Heung Joon Kim ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Ischemic Stroke ◽  
Magnetic Resonance ◽  
Resonance Imaging

scholarly journals Magnetic Resonance Imaging and Clinical Factors Associated With Ischemic Stroke in Patients Suspected of Cervical Artery Dissection

Stroke ◽  
2018 ◽  
Vol 49 (10) ◽  
pp. 2337-2344 ◽  
Author(s):  
J. Scott McNally ◽  
Peter J. Hinckley ◽  
Akihiko Sakata ◽  
Laura B. Eisenmenger ◽  
Seong-Eun Kim ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Ischemic Stroke ◽  
Magnetic Resonance ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Resonance Imaging ◽  
Clinical Factors ◽  
Factors Associated ◽  
Cervical Artery

Magnetic Resonance Imaging in Gynecological Oncology

2009 ◽  
Vol 19 (2) ◽  
pp. 186-193 ◽  
Author(s):  
Vanessa N. Harry ◽  
Heather Deans ◽  
Emma Ramage ◽  
David E. Parkin ◽  
Fiona J. Gilbert
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Early Assessment ◽  
Contrast Enhanced ◽  
Crucial Information ◽  
Magnetic Resonance Imaging Mri ◽  
Indispensable Tool ◽  
Improving Patient Care

Magnetic resonance imaging (MRI) has become an indispensable tool in the assessment of malignant disease. With increasingly sophisticated systems and technical advancements, MRI has continued to expand its role in providing crucial information regarding cancer diagnosis and management. In gynecological malignancies, this modality has assumed greater responsibility, particularly in the evaluation of cervical and endometrial cancers. In addition to conventional imaging, innovative techniques such as dynamic contrast-enhanced MRI and diffusion-weighted MRI show promise in offering early assessment of tumor response. This paper reviews the current role of MRI in gynecological cancers and highlights the potential of novel techniques in improving patient care.

Diffusion imaging of cerebral diaschisis in childhood arterial ischemic stroke

2016 ◽  
Vol 11 (9) ◽  
pp. 1028-1035 ◽  
Author(s):  
Adam Kirton ◽  
Elizabeth Williams ◽  
Michael Dowling ◽  
Sarah Mah ◽  
Jacquie Hodge ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Ischemic Stroke ◽  
Magnetic Resonance ◽  
Diffusion Weighted Imaging ◽  
Infarct Volume ◽  
Resonance Imaging ◽  
Arterial Ischemic Stroke ◽  
Diffusion Weighted ◽  
Motor Outcome

Background Diffusion-weighted imaging magnetic resonance imaging may detect changes in brain structures remote but connected to stroke consistent with neuropathological descriptions of diaschisis. Early diffusion-weighted imaging demonstrates restriction in corticospinal pathways after arterial ischemic stroke of all ages that correlates with motor outcome. Aim/hypothesis We hypothesized that cerebral diaschisis is measurable in childhood arterial ischemic stroke and explored associations with outcome. Methods This sub-study of the validation of the Pediatric NIH Stroke Scale study prospectively enrolled children with acute arterial ischemic stroke and both acute and early follow-up (5–14 days) diffusion-weighted imaging. Inclusion criteria were (1) unilateral middle cerebral artery arterial ischemic stroke, (2) acute and subacute diffusion-weighted imaging ( b = 1000), and (3) 12 month neurological follow-up (Pediatric Stroke Outcome Measure). A validated method using ImageJ software quantified diffusion-weighted imaging diaschisis in anatomically connected structures. Diaschisis measures were corrected for infarct volume, compared to age, imaging timing, and outcomes (Chi square/Fisher, Mann–Whitney test). Results Nineteen children (53% male, median 8.1 years) had magnetic resonance imaging at medians of 21 and 168 h post-stroke onset. Diaschisis was common and evolved over time, observed in one (5%) on acute but eight (42%) by follow-up diffusion-weighted imaging. Thalamic and callosal diaschisis were most common (5, 26%). Estimates of perilesional diaschisis varied (54 ± 18% of infarct volume). Children with diaschisis tended to be younger (7.02 ± 5.4 vs. 11.82 ± 4.3 years, p = 0.08). Total diaschisis score was associated with poor cognitive outcomes ( p = 0.03). Corticospinal tract diaschisis was associated with motor outcome ( p = 0.004). Method reliability was excellent. Conclusions Diffusion-weighted imaging diaschisis occurs in childhood arterial ischemic stroke. Mistaking diaschisis for new areas of infarction carries important clinical implications. Improved recognition and study are required to establish clinical relevance.

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