Gurubharath, I (2016) Diffusion - weighted MR imaging versus CT brain – Diagnostic accuracy in hyperacute stroke. Doctoral thesis, Madras Medical College, Chennai.
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Abstract
PURPOSE : To compare the diagnostic accuracy of non-enhanced computed tomography (NECT) and Diffusion-weighted magnetic resonance imaging (DW MRI) in a consecutive series of patients at presentation to the radiology department with symptoms of hyperacute stroke and aiding the clinicians in instituting the treatment protocol at the earliest. MATERIALS AND METHODS : Clinical data, NECT and DW MRI and conventional MR images obtained in 200 consecutive patients with suspected hyperacute stroke were examined. Results of the diffusion-weighted imaging and NECT were compared with each other and correlated with the final discharge diagnosis. RESULTS : Of the 200 patients with symptoms and signs of stroke within the hyperacute stroke window period, diffusion-weighted images indicated stroke in 180 patients. Diffusionweighted images were negative in 20 patients. The 20 patients with negative DWI were diagnosed with stroke mimics. Of the 200 patients, NECT was positive in 99 patients with imaging features of early infarction signs. Statistical reviews yielded 96.7% sensitivity (95% CI, 92.8%-98.7%) and 90% Specificity (95% CI, 68.3%- 98.7%) for diffusion-weighted MR imaging and NECT had a sensitivity and specificity of 88% (95% CI, 80.9%- 94,3%) and 63.5% (95% CI, 37%-71,5%) respectively. The DWMRI had a higher accuracy rate of 96% (95% CI, 92.3%, 98.2%) than with 50.5% in NECT (95%CI 43.3%, 57.6%). CONCLUSION: DWMRI is replacing NECT in the imaging of hyperacute stroke patients. DWI and NECT imaging done with the same delay after onset of symptoms of hyperacute stroke resulted in significant differences in diagnostic accuracy. The study concludes with higher accuracy rate of diffusion-weighted MR imaging in diagnosing hyperacute stroke than NECT. The size of the lesion measured by DWI scans and apparent diffusion coefficient (ADC) values are potential imaging parameters for predicting the clinical outcome in hyperacute stroke patients. Our study supports the inclusion of DWMRI in the routine imaging protocol for diagnosing hyperacute stroke and thus aiding the clinicians in deciding the treatment protocols at the earliest.
| Item Type: | Thesis (Doctoral) |
|---|---|
| Uncontrolled Keywords: | Diffusion ; weighted MR imaging ; CT brain ; Diagnostic accuracy ; hyperacute stroke. |
| Subjects: | Respiratory Medicine > Radio Diagnosis > Respiratory Medicine > Radio Diagnosis |
| Depositing User: | Subramani R |
| Date Deposited: | 19 Aug 2017 08:41 |
| Last Modified: | 22 Sep 2022 09:31 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/2699 |
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