But are these other fast stroke diagnosis tools good enough to roll out to the world? Do you even know about them?
Another reason to switch to artificial intelligence to diagnose strokes. Maybe one of these much faster methods:
Hats off to Helmet of Hope - stroke diagnosis in 30 seconds
Microwave Imaging for Brain Stroke Detection and Monitoring using High Performance Computing in 94 seconds
New Device Quickly Assesses Brain Bleeding in Head Injuries - 5-10 minutes
http://dgnews.docguide.com/imaging-without-contrast-may-not-be-appropriate-diagnose-acute-posterior-fossa-ischemic-stroke?
By Brian Hoyle
SAN DIEGO -- October 18, 2017 -- A systematic review of the relevant literature has highlighted the caution needed in interpreting neuroimaging, particularly using non-contrast computed tomography (NCCT) in diagnosing ischaemic stroke.
The use of magnetic resonance imaging-diffusion weighted imaging (MRI-DWI) could be a better approach, with some caveats, according to the study presented here at the 142nd Annual Meeting of the American Neurological Association (ANA).
“In current emergency department practice, NCCT is often used to ‘rule out’ stroke in patients with potential posterior circulation symptoms like dizziness or vertigo,” wrote Vahid Eslami, MD, John Hopkins University School of Medicine, Baltimore, Maryland, and colleagues in their presentation. “However, our results indicate that NCCT is inadequate for detecting acute posterior fossa ischemic stroke. MRI-DWI outperforms NCCT for detecting infratentorial strokes.”
However, when MRI-DWI is used, it must be used with the knowledge that false-negative results occur in about one-quarter of brainstem strokes during the first 48 hours after the onset of stroke.
The findings and suggestions resulted from a literature search of MEDLINE and Embase for articles published from 1990 to 2016. The search was for papers that described the sensitivity and specificity of MRI or CT in patients with imaging-confirmed acute infratentorial stroke within the prior 72 hours.
The search ultimately identified 186 articles. Of these, 14 articles were analysed. Eight articles involved MRI, 5 involved NCCT, and 1 study involved both imaging techniques. The articles included 879 patients; 810 had stroke, with MRI and CT used in 492 and 318 cases, respectively, and 69 patients did not have stroke, with MRI and CT used in 23 and 46 cases, respectively.
MRI-DWI was more sensitive than NCCT (76.4% vs 30.8%; P < .001). The specificity of MRI-DWI and NCCT was similar (91.3% vs 97.8%; P = .26). False-negative MRI-DWI results were most often reported for brainstem strokes, and only within 48 hours after symptom onset.
“For patients presenting acute, non-specific, potentially posterior circulation symptoms, such as dizziness or vertigo, providers should consider alternative diagnostic strategies shown to have higher sensitivity for acute stroke diagnosis,” the authors wrote.
These strategies include eye movement-based physiologic diagnosis. If the alternatives are not available for high-risk patients, the researchers suggest that repeat MRI-DWI is warranted after the first few days of stroke onset to reduce the chance of a false-negative result.
[Presentation title: False Negative MRI-DWI and CT in Diagnosing Acute Posterior Fossa Ischemic Stroke: a Systematic Review. Abstract M145]
SAN DIEGO -- October 18, 2017 -- A systematic review of the relevant literature has highlighted the caution needed in interpreting neuroimaging, particularly using non-contrast computed tomography (NCCT) in diagnosing ischaemic stroke.
The use of magnetic resonance imaging-diffusion weighted imaging (MRI-DWI) could be a better approach, with some caveats, according to the study presented here at the 142nd Annual Meeting of the American Neurological Association (ANA).
“In current emergency department practice, NCCT is often used to ‘rule out’ stroke in patients with potential posterior circulation symptoms like dizziness or vertigo,” wrote Vahid Eslami, MD, John Hopkins University School of Medicine, Baltimore, Maryland, and colleagues in their presentation. “However, our results indicate that NCCT is inadequate for detecting acute posterior fossa ischemic stroke. MRI-DWI outperforms NCCT for detecting infratentorial strokes.”
However, when MRI-DWI is used, it must be used with the knowledge that false-negative results occur in about one-quarter of brainstem strokes during the first 48 hours after the onset of stroke.
The findings and suggestions resulted from a literature search of MEDLINE and Embase for articles published from 1990 to 2016. The search was for papers that described the sensitivity and specificity of MRI or CT in patients with imaging-confirmed acute infratentorial stroke within the prior 72 hours.
The search ultimately identified 186 articles. Of these, 14 articles were analysed. Eight articles involved MRI, 5 involved NCCT, and 1 study involved both imaging techniques. The articles included 879 patients; 810 had stroke, with MRI and CT used in 492 and 318 cases, respectively, and 69 patients did not have stroke, with MRI and CT used in 23 and 46 cases, respectively.
MRI-DWI was more sensitive than NCCT (76.4% vs 30.8%; P < .001). The specificity of MRI-DWI and NCCT was similar (91.3% vs 97.8%; P = .26). False-negative MRI-DWI results were most often reported for brainstem strokes, and only within 48 hours after symptom onset.
“For patients presenting acute, non-specific, potentially posterior circulation symptoms, such as dizziness or vertigo, providers should consider alternative diagnostic strategies shown to have higher sensitivity for acute stroke diagnosis,” the authors wrote.
These strategies include eye movement-based physiologic diagnosis. If the alternatives are not available for high-risk patients, the researchers suggest that repeat MRI-DWI is warranted after the first few days of stroke onset to reduce the chance of a false-negative result.
[Presentation title: False Negative MRI-DWI and CT in Diagnosing Acute Posterior Fossa Ischemic Stroke: a Systematic Review. Abstract M145]
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