Wednesday, April 16, 2025

Prognostic Value of Adding Magnetic Resonance Imaging to Computed Tomography in Acute Ischemic Stroke

 What stupidity, an additional scan does not lead to better recovery! You don't understand cause and effect at all!

Prognostic Value of Adding Magnetic Resonance Imaging to Computed Tomography in Acute Ischemic Stroke

First published: 15 April 2025

Funding: The authors received no specific funding for this work.

Kaixiang Chen and Jiafeng Ni contributed equally to this study.

ABSTRACT

Objective

To assess if magnetic resonance imaging (MRI) provides additional benefits over computed tomography (CT) in patients with acute ischemic stroke (AIS).

Methods

We retrospectively reviewed adult AIS patients who underwent an initial CT scan and received intravenous thrombolysis using rt-PA, dividing them into two groups: MRI plus CT and CT alone. Propensity-score matching (PSM) analysis was employed to reduce confounding biases.

Results

After PSM, two matched groups (168 pairs, n = 336 patients) were generated. There were no significant differences in the modified Rankin Scale (mRS) scores of 0–2 or 0–1 at 3 months between the two groups (both p > 0.05). Patients in the MRI plus CT group had significantly lower incidence rates of 7-day mortality (3.0% vs. 8.9%, p = 0.04), 30-day mortality (11.3% vs. 21.4%, p = 0.02), and symptomatic intracranial hemorrhage (SICH, 11.9% vs. 23.2%, p = 0.01). Multivariate logistic regression showed that the MRI plus CT-based regimen significantly reduced the risks of 7-day (OR = 0.02, 95% CI: 0.01–0.18; p < 0.01) and 30-day mortality (OR = 0.03, 95% CI: 0.01–0.13; p < 0.01), as well as SICH (OR = 0.27, 95% CI: 0.09–0.76; p = 0.01).

Conclusion

The addition of MRI to CT enhances prognostic value in AIS patients, as it is associated with significantly reduced risks of mortality and SICH.

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