Optimization of MRI brain protocol for stroke patients.

Abstract

A stroke is a sudden interruption in the blood supply to the brain. Most strokes are caused by an abrupt blockage of arteries leading to the brain (ischemic stroke). Other strokes are caused by bleeding into brain tissue when a blood vessel bursts (hemorrhagic stroke). According to the World Health Organization, 15 million people suffer stroke worldwide each year. Of these, 5 million die and another 5 million are permanently disabled. High blood pressure contributes to over 12.7 million strokes worldwide and Europe averages approximately 650,000 stroke deaths each year (Bakshi et al.,2001). There are various types of stroke however Ischemic stroke is by far the most common kind of stroke, accounting for about 88% of all strokes. At the moment at the acute general public hospital in Malta (thereupon referred to the local context), MRI imaging protocol for patients undergoing MRI brain examinations suffering from stroke consists of Axial STIR imaging, sagittal T2- Weighted (T2W) FSE imaging, coronal Tl- Weighted (Tl W) FLAIR imaging, Axial T2- weighted FLAIR imaging and Diffusion - Weighted imaging. However this study investigates the real need of all these 5 sequences in the case of patients suffering from a stroke. Images of patients that had already done their brain MRI scan were used and shown to the consenting radiologists who gave their opinion on each sequence identifying from them from best to the least informative sequence in a form of a check list. The study aims: • To establish whether or not all five sequences for brain MR images are essential for diagnosis and treatment in follow-up examination of patients suffering from stroke.