The use of magnetic resonance imaging as a first-choice diagnostic method in emergency vascular neurology

Authors:
Open Access
Publisher website
Google Scholar
Abstract
Background. Reducing time from the onset of first symptoms of acute cerebrovascular accident to patient admission to a stroke center and performing neuroimaging (CT or MRI) for diagnosis verification not only aids in diagnosing emergency conditions in emergency vascular neurology but also helps shorten the time to treatment initiation, thereby contributing to improved clinical outcomes. Aim. To assess the use of MRI as the first-choice diagnostic method in adults transported by emergency medical services (EMS) with suspected acute cerebrovascular accident. Materials and methods. This single-center observational study included adults (≥18 years) transported to the Federal Center of Brain Research and Neurotechnologies from January 1 to December 31, 2025 with suspected acute cerebrovascular accident were included. MRI was used as the initial imaging modality in the absence of contraindications; CT was performed when MRI was contraindicated. Time metrics, imaging utilization, reperfusion therapy and in-hospital mortality were analyzed. Results. During the observation period, 712 patients with suspected acute stroke were transported by EMS; acute cerebrovascular accident was confirmed in 482 (67.7%) patients, while in 230 (32.3%) cases another diagnosis was made: 80 (11.2%) patients were found to have other neurological pathologies that required hospitalization, 15 (2.1%) cases were diagnosed with somatic pathologies, and these patients were also hospitalized, while 135 (19%) cases did not require hospitalization. MRI was performed in 611 cases (85.8%) and CT in 101 (14.2%). Median door-to-imaging time was 17 min. Reperfusion therapy for ischemic stroke was delivered in 59 patients. Overall in-hospital mortality among admitted patients was 3.1%, and mortality in acute cerebrovascular accidents was 4.1%. Conclusion. The use of MRI as a first-choice diagnostic method in patients with suspected acute stroke in a 24/7 hospital allows for rapid neuroimaging, providing a more accurate diagnosis and reducing unnecessary hospital admissions of patients with alternative diagnoses – «stroke mimics».

This publication has 22 references indexed in Scilit: