A Comparative Analysis of Diagnostic Imaging in Acute Ischaemic Stroke

  • Dupinder Kaur Research Scholar, NIMS University, Jaipur, Rajasthan, India.
  • RP Bansal Professor & Head, Department of Radio-diagnosis, National Institute of Medical Sciences & Research, NIMS University, Jaipur, Rajasthan, India.
  • Ashok Uppal Associate Professor, Guru Nanak Dev University, Amritsar, Punjab, India.
Keywords: MRI, AIS, Acute Ischaemic Stroke, Thrombolysis, Computed Tomography, CT, Ischaemic Stroke, Magnetic Resonance Imaging

Abstract

Introduction: Acute ischaemic stroke (AIS) is responsible for almost 90% of all strokes. Large vessel occlusion is mainly responsible for AIS. Earlier treatment of AIS is associated with improved outcomes. Multimodal imaging methods such as MRI and CT provide information that can help in diagnosing it. These methods are helpful in the prognosis of AIS and in the selection of patients who can be subjected to thrombolytic therapy.

Objectives of the Study: The present comparative study has been conducted to understand whether MRI images are better for the diagnosis of AIS than CT, to assess the efficacy of tPA in the recovery of patients, and to explore the role of advanced imaging in acute stroke.

Methods: The present study was conducted with 40 patients, aged 18 years and above who presented to the Emergency Department of Uppal Neuro Hospital, Amritsar, Punjab with a history of acute ischaemic stroke or hyperacute stroke between September 2017 and March 2018. All patients were examined using 32 slices CT and 1.5T MRI scanner. Among all cases, 17 patients had suffered a hyperacute stroke and 23 had suffered an acute ischaemic stroke.

Conclusion: Sophisticated techniques such as perfusion imaging and non-invasive vascular imaging are becoming more effective tools for guiding prospective endovascular treatment or extending therapy windows in the case of patients with acute ischaemic stroke.

How to cite this article: Kaur D, Bansal RP, Uppal A. A Comparative Analysis of Diagnostic Imaging in Acute Ischaemic Stroke. Chettinad Health City Med J. 2023;12(2):3-8.

DOI: https://doi.org/10.24321/2278.2044.202320

References

Sundaram VK, Goldstein J, Wheelwright D, Aggarwal A, Pawha PS, Doshi A, Fifi JT, Leacy RD, Mocco J, Puig J, Nael K. Automated ASPECTS in acute ischemic stroke: a comparative analysis with CT perfusion. AJNR Am J Neuroradiol. 2019;40(12):2033. [PubMed] [Google Scholar]

Zhang R, Zhao L, Lou W, Abrigo JM, Mok VC, Chu WC, Wang D, Shi L. Automatic segmentation of acute ischemic stroke from DWI using 3-D fully convolutional DenseNets. IEEE Trans Med Imaging. 2018;37(9):2149-60. [PubMed] [Google Scholar]

Jahan R, Saver JL, Schwamm LH, Fonarow GC, Liang L, Matsouaka RA, Xian Y, Holmes DN, Peterson ED, Yavagal D, Smith EE. Association between time to treatment with endovascular reperfusion therapy and outcomes in patients with acute ischemic stroke treated in clinical practice. JAMA. 2019;322(3):252-63. [PubMed] [Google Scholar]

Tsivgoulis G, Geisler F, Katsanos AH, K├Árv J, Kunz A, Mikulik R, Rozanski M, Wendt M, Audebert HJ. Ultraearly intravenous thrombolysis for acute ischemic stroke in mobile stroke unit and hospital settings: a comparative analysis. Stroke. 2018;49(8):1996-9. [PubMed] [Google Scholar]

Demeestere J, Wouters A, Christensen S, Lemmens R, Lansberg MG. Review of perfusion imaging in acute ischemic stroke: from time to tissue. Stroke. 2020;51(3):1017-24. [PubMed] [Google Scholar]

Kim JT, Cho BH, Choi KH, Park MS, Kim BJ, Park JM, Kang K, Lee SJ, Kim JG, Cha JK, Kim DH, Nah HW, Park TH, Park SS, Lee KB, Lee J, Hong KS, Cho YJ, Park HK, Lee BC, Yu KH, Oh MS, Kim DE, Ryu WS, Choi JC, Kwon JH, Kim WJ, Shin DI, Yeo MJ, Sohn SI, Hong JH, Lee JS, Lee J, Bae HJ, Cho KH. Magnetic resonance imaging versus computed tomography angiography based selection for endovascular therapy in patients with acute ischemic stroke. Stroke. 2019;50(2):365-72. [PubMed] [Google Scholar]

Zerna C, Thomalla G, Campbell BC, Rha JH, Hill MD. Current practice and future directions in the diagnosis and acute treatment of ischaemic stroke. Lancet. 2018;392(10154):1247-56. [PubMed] [Google Scholar]

Rajashekar D, Hill MD, Demchuk AM, Goyal M, Fiehler J, Forkert ND. Prediction of clinical outcomes in acute ischaemic stroke patients: a comparative study. Front Neurol. 2021;12:678. [PubMed] [Google Scholar]

Mokin M, Ansari SA, McTaggart RA, Bulsara KR, Goyal M, Chen M, Fraser JF; Society of NeuroInterventional Surgery. Indications for thrombectomy in acute ischemic stroke from emergent large vessel occlusion (ELVO): report of the SNIS Standards and Guidelines Committee. J Neurointerv Surg. 2019;11(3):215-20. [PubMed] [Google Scholar]

Tao J, Cai Y, Dai Y, Xie Y, Liu H, Zang X. Value of 4D CT angiography combined with whole brain CT perfusion imaging feature analysis under deep learning in imaging examination of acute ischemic stroke. Comput Intell Neurosci. 2022;2022:2286413. [PubMed] [Google Scholar]

Kwon Y, Won JH, Kim BJ, Paik MC. Uncertainty quantification using Bayesian neural networks in classification: application to ischemic stroke lesion segmentation. Medical Imaging with Deep Learning. 2018. [Google Scholar]

Sharma R, Silverman S, Patel S, Schwamm LH, Sanborn DY. Frequency, predictors and cardiovascular outcomes associated with transthoracic echocardiographic findings during acute ischaemic stroke hospitalisation. Stroke Vasc Neurol. 2022;7(6):482-92. [PubMed] [Google Scholar]

Provost C, Soudant M, Legrand L, Ben Hassen WB, Xie Y, Soize S, Borcier R, Benzakoun J, Edjlali M, Boulousi G, Raoult H, Guillemin F, Naggara O, Bracard S, Oppenheim C. Magnetic resonance imaging or computed tomography before treatment in acute ischemic stroke: effect on workflow and functional outcome. Stroke. 2019;50(3):659-64. [Google Scholar]

Jeena RS, Kumar S. A comparative analysis of MRI and CT brain images for stroke diagnosis. 2013 Annual International Conference on Emerging Research Areas and 2013 International Conference on Microelectronics, Communications and Renewable Energy. 2013. p. 1-5. [Google Scholar]

Kim BJ, Kang HG, Kim HJ, Ahn SH, Kim NY, Warach S, Kang DW. Magnetic resonance imaging in acute ischemic stroke treatment . J Stroke. 2014;16(3):131. [PubMed] [Google Scholar]

Macha K, Hoelter P, Siedler G, Knott M, Schwab S, Doerfler A, Kallmunzer B, Engelhorn T. Multimodal CT or MRI for IV thrombolysis in ischemic stroke with unknown time of onset. Neurology. 2020;95(22):e2954-64. [PubMed] [Google Scholar]

Wang Y, Jing J, Meng X, Pan Y, Wang Y, Zhao X, Lin J, Li W, Jiang Y, Li Z, Zhang X, Yang X, Ji R, Wang C, Wang Z, Han X, Wu S, Jia Z, Chen Y, Li H. The third China National Stroke Registry (CNSR-III) for patients with acute ischaemic stroke or transient ischaemic attack: design, rationale and baseline patient characteristics. Stroke Vasc Neurol. 2019;4(3):158-64. [PubMed] [Google Scholar]

Rudkin S, Cerejo R, Tayal A, Goldberg MF. Imaging of acute ischemic stroke. Emerg Radiol. 2018;25(6):659-72. [Google Scholar]

Fotrousi F, Seyff N, Borstler J. Ethical considerations in research on user feedback. 2017 IEEE 25th International Requirements Engineering Conference Workshops (REW). 2017. p. 194-8. [Google Scholar]

Arifin SR. Ethical considerations in qualitative study. Int J Care Scholars. 2018;1(2):30-3. [Google Scholar]

Psychogios K, Tsivgoulis G. Intravenous thrombolysis for acute ischemic stroke: why not? Curr Opin Neurol. 2022;35(1):10-7. [PubMed] [Google Scholar]

Grotta JC. Intravenous thrombolysis for acute ischemic stroke. Continuum (Minneap Minn). 2023;29(2):425-42. [PubMed] [Google Scholar]

Lansberg MG, Albers GW, Beaulieu C, Marks MP. Comparison of diffusion-weighted MRI and CT in acute stroke. Neurology. 2000;54(8):1557-61. [PubMed] [Google Scholar]

Published
2023-06-30