MR Imaging Helps PredictTime from Symptom Onset in

Patients with Acute Stroke:Implications for Patients with

Unknown Onset TimeRadiology: Volume 257: Number 3—December 2010

Agung Nugroho, drPembimbing :

Prof. Dr. Triyono KSP, dr., Sp.Rad (K)

Introduction

One of the major contraindications to thrombolysis is an unknown stroke onset time

Up to ¼ patients have been excludedfrom thrombolytic trials because the

stroke was noticed on awakening or theonset was not witnessed

Introduction

The absence of a signal intensity increase on fluid-attenuated inversion recovery (FLAIR) MR images in the presence of a corresponding area of high signal intensity on DW images shown to help identify patients within 3 hours after stroke onset with high specificity but low sensitivity

Introduction

Predictive values of FLAIR MR imaging

Predictive values of DW MR imaging

Apparent diffusion coefficient (ADC) measurements

Value of MR imaging parameters

as surrogate

markers of stroke

duration

Material and Methods

Inclusion Criteria Exclusion criteria• Patients with acute

stroke admitted May 2006- October 2008

• Well defined stroke onset time

• Had undergone MR imaging within 12 hours of stroke onset

• NIHSS >3

• Stroke on awakening• Screening by CT• FLAIR images has major

artifact

Material and Methods

Among 907 pts admitted for acute stroke, 777 (85,7%) were excluded

130 Pts (14,3%) included in study group

Data recorded for :Demografic details, Stroke onset to imaging delay, NIHSS score at admission, arterial distribution, infarct size on DW images, affected side, motion artifact on FLAIR, treatment with trhrombolysis, Outcome with MRS