Six-Minute Magnetic Resonance Imaging Protocol for Evaluation of Acute Ischemic Stroke

So what. This will be obsolete soon.  Because of these;
Maybe when we get actual objective diagnosis when these come online:
1. Star Trek-style 'tricorder' invention offered $10m prize
2. Strokefinder quickly differentiates bleeding strokes from clot-induced strokes
3.  One of these 17 ways still need to be be proven for fast and objective diagnosis.

Six minute MRI here:
http://stroke.ahajournals.org/content/45/7/1985.abstract?etoc

Pushing the Boundaries

1. Kambiz Nael, MD;
2. Rihan Khan, MD;
3. Gagandeep Choudhary, MD;
4. Arash Meshksar, MD;
5. Pablo Villablanca, MD;
6. Jennifer Tay, MD;
7. Kendra Drake, MD;
8. Bruce M. Coull, MD;
9. Chelsea S. Kidwell, MD

+ Author Affiliations

1. From the Departments of Medical Imaging (K.N., R.K., G.C., A.M., C.S.K.) and Neurology (J.T., K.D., B.M.C., C.S.K.), University of Arizona, Tucson; and Department of Radiological Sciences, University of California, Los Angeles (P.V.).

1. Correspondence to Kambiz Nael, MD, Neuroradiology Section, Department of Medical Imaging, University of Arizona Medical Center, 1501 N Campbell, PO Box 245067, Tucson, AZ 85724. E-mail kambiznael@gmail.com

Abstract

Background and Purpose—If magnetic resonance imaging (MRI) is to compete with computed tomography for evaluation of patients with acute ischemic stroke, there is a need for further improvements in acquisition speed.

Methods—Inclusion criteria for this prospective, single institutional study were symptoms of acute ischemic stroke within 24 hours onset, National Institutes of Health Stroke Scale ≥3, and absence of MRI contraindications. A combination of echo-planar imaging (EPI) and a parallel acquisition technique were used on a 3T magnetic resonance (MR) scanner to accelerate the acquisition time. Image analysis was performed independently by 2 neuroradiologists.

Results—A total of 62 patients met inclusion criteria. A repeat MRI scan was performed in 22 patients resulting in a total of 84 MRIs available for analysis. Diagnostic image quality was achieved in 100% of diffusion-weighted imaging, 100% EPI-fluid attenuation inversion recovery imaging, 98% EPI-gradient recalled echo, 90% neck MR angiography and 96% of brain MR angiography, and 94% of dynamic susceptibility contrast perfusion scans with interobserver agreements (k) ranging from 0.64 to 0.84. Fifty-nine patients (95%) had acute infarction. There was good interobserver agreement for EPI-fluid attenuation inversion recovery imaging findings (k=0.78; 95% confidence interval, 0.66–0.87) and for detection of mismatch classification using dynamic susceptibility contrast-Tmax (k=0.92; 95% confidence interval, 0.87–0.94). Thirteen acute intracranial hemorrhages were detected on EPI-gradient recalled echo by both observers. A total of 68 and 72 segmental arterial stenoses were detected on contrast-enhanced MR angiography of the neck and brain with k=0.93, 95% confidence interval, 0.84 to 0.96 and 0.87, 95% confidence interval, 0.80 to 0.90, respectively.

Conclusions—A 6-minute multimodal MR protocol with good diagnostic quality is feasible for the evaluation of patients with acute ischemic stroke and can result in significant reduction in scan time rivaling that of the multimodal computed tomographic protocol.