CT Imaging Alone Found Noninferior to CT/MR Combo for Acute Ischemic Stroke Patients

More than 90% of patients with acute ischemic stroke (AIS) receive magnetic resonance imaging (MRI) in addition to computed tomography (CT) with few data to determine whether there is an associated benefit with patient outcomes. Now, a new study of patients hospitalized with AIS has found that a diagnostic imaging strategy of initial CT alone was noninferior to initial CT with additional MRI with regard to the clinical outcomes of death or dependence at hospital discharge or prevention of stroke or death at one year after discharge.

The study by researchers at the Duke University Medical Center (Durham, NC, USA) involved 246 participants with a median age of 68 years and 131 being men (53%). The researchers found that death or dependence at discharge occurred more often in patients with additional MRI (59 of 123 [48%]) than in those with CT alone (52 of 123 [42.3%]); meeting the −7.50% criterion for noninferiority. Stroke or death within one year after discharge determined for 225 of 235 (96%) survivors occurred more often in patients with additional MRI (22 of 113 [19.5%]) than in those with CT alone (14 of 112 [12.5%]), meeting the 0.725 relative risk criterion for noninferiority.

Based on the findings of the propensity score-matched cohort study of patients hospitalized with AIS, the researchers concluded that a diagnostic imaging strategy of initial CT alone was noninferior to initial CT plus additional MRI with regard to clinical outcomes at discharge and at one year. Further research is needed to determine which patients hospitalized with acute ischemic stroke benefit from MRI, according to the researchers.

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Duke University Medical Center