BMJ  2004;328:1135 (8 May), doi:10.1136/bmj.328.7448.1135

Letter

Scan immediately for stroke using MRI when possible

The first 150 words of the full text of this article appear below.

EDITOR—We agree with Wardlaw and Farrall that a strategy to scan all patients immediately for stroke is optimal.1 They say that magnetic resonance imaging (MRI) has some perceived disadvantages in imaging acute stroke, despite its advantages.

In our experience, the advantages of an early imaging strategy with magnetic resonance imaging outweigh its disadvantages. By combining diffusion weighted imaging with a T2 weighted gradient sequence the sensitivity for both infarction and haemorrhage is high (figure). The room times for this technique are similar to computed tomography, and most patients can be scanned by magnetic resonance imaging.2 The interpretation of the scans is more straightforward and their reproducibility high.3


Figure Removed (Available Only in the Full Text)
Figure Removed (Available Only in the Full Text)
 Top: MRI T2 gradient image showing intracerebral haemorrhage as low signal due to deoxyhaemoglobin susceptibility. Bottom: Diffusion MRI image (B1000) showing acute infarction as high signal (acquisition time 1 minute)

 

In a British district general hospital where there may . . . [Full text of this article]

Dennis P Briley, consultant neurologist

dennis.briley@smh.nhs.uk

Thomas Meagher, consultant radiologist

Stoke Mandeville Hospital, Aylesbury, Buckinghamshire HP21 8AL


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Relevant Article

Diagnosis of stroke on neuroimaging
J M Wardlaw and A J Farrall
BMJ 2004 328: 655-656. [Extract] [Full Text] [PDF]

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