Magnetic Resonance Imaging or Computed Tomography Before Treatment in Acute Ischemic Stroke: Effect on Workflow and Functional Outcome
| العنوان: | Magnetic Resonance Imaging or Computed Tomography Before Treatment in Acute Ischemic Stroke: Effect on Workflow and Functional Outcome |
|---|---|
| المؤلفون: | Corentin Provost, Hélène Raoult, Laurence Legrand, Yu Xie, Gregoire Boulouis, Marc Soudant, Francis Guillemin, Catherine Oppenheim, Wagih Ben Hassen, Olivier Naggara, Myriam Edjlali, Joseph Benzakoun, Serge Bracard, Romain Bourcier, Sébastien Soize |
| المساهمون: | Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Centre d'Investigation Clinique - Innovation Technologique [Nancy] (CIC-IT), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de neuroradiologie diagnostique et thérapeutique [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Universitaire de Reims (CHU Reims), Centre hospitalier universitaire de Nantes (CHU Nantes), Service de Neuroradiologie [Rennes], CHU Pontchaillou [Rennes], BIRKER, Juliette, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL) |
| المصدر: | Stroke Stroke, American Heart Association, 2019, 50 (3), pp.659-664. ⟨10.1161/STROKEAHA.118.023882⟩ |
| بيانات النشر: | HAL CCSD, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | workflow, [INFO.INFO-IM] Computer Science [cs]/Medical Imaging, Computed tomography, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, [SDV.IB.MN] Life Sciences [q-bio]/Bioengineering/Nuclear medicine, 030218 nuclear medicine & medical imaging, law.invention, Brain ischemia, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Interquartile range, Modified Rankin Scale, medicine, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, magnetic resonance imaging, Acute ischemic stroke, Advanced and Specialized Nursing, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, medicine.diagnostic_test, business.industry, Magnetic resonance imaging, medicine.disease, brain ischemia, 3. Good health, Clinical trial, thrombectomy, treatment outcome, Neurology (clinical), Cardiology and Cardiovascular Medicine, Nuclear medicine, business, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology |
| الوصف: | Background and Purpose— The acute management of stroke patients requires a fast and efficient screening imaging modality. We compared workflow and functional outcome in acute ischemic stroke patients screened by magnetic resonance imaging (MRI) or computed tomography (CT) before treatment in the THRACE trial (Thrombectomie des Artères Cérébrales), with the emphasis on the duration of the imaging step. Methods— The THRACE randomized trial (June 2010 to February 2015) evaluated the efficacy of mechanical thrombectomy after intravenous tPA (tissue-type plasminogen activator) in ischemic stroke patients with proximal occlusion. The choice of screening imaging modality was left to each enrolling center. Differences between MRI and CT groups were assessed using univariable analysis and the impact of imaging modality on favorable 3-month functional outcome (modified Rankin Scale score of ≤2) was tested using multivariable logistic regression. Results— Four hundred one patients were included (25 centers), comprising 299 MRI-selected and 102 CT-selected patients. Median baseline National Institutes of Health Stroke Scale score was 18 in both groups. MRI scan duration (median [interquartile range]) was longer than CT (MRI: 13 minutes [10–16]; CT: 9 minutes [7–12]; P P =0.19), onset-to-intravenous tPA time (MRI: 150 minutes [124–179]; CT: 150 minutes [123–180]; P =0.38) and onset-to-angiography-suite time (MRI: 200 minutes [170–250]; CT: 213 minutes [180–246]; P =0.57) did not differ between groups. Imaging modality was not significantly associated with functional outcome in the multivariable analysis. Conclusions— Although MRI scan duration is slightly longer than CT, MRI-based selection for acute ischemic stroke patients is accomplished within a timeframe similar to CT-based selection, without delaying treatment or impacting functional outcome. This should help to promote wider use of MRI, which has inherent imaging advantages over CT. Clinical Trial Registration— URL: https://www.clinicaltrials.govTest . Unique identifier: NCT01062698. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 0039-2499 1524-4628 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9a4d3ad7ed52319d360122e437baff46Test https://hal.univ-lorraine.fr/hal-03220929/file/STROKEAHA.118.023882.pdfTest |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....9a4d3ad7ed52319d360122e437baff46 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 00392499 15244628 |
|---|