The possibilities of an improved magnetic resonance imaging protocol in the diagnosis of acute ischemic stroke

Background. The most important advantage that imaging provides to a patient with ischemic stroke is the rapid identification of those patients who are most likely to benefit from emergency treatment. This group includes patients who suffer from severe neurological symptoms due to occlusion of the main artery, and those who are candidates for recanalization using intravenous thrombolysis or intraarterial intervention to remove a blood clot. Objective. To develop an improved protocol (set of pulse sequences) of magnetic resonance imaging for patients in the acute period of ischemic stroke. Materials and methods. The experience of clinical use of brain MRI at the Almazov National Medical Research Centre in patients with ischemic stroke is analyzed. Results. The most sensitive in the diagnosis of ischemic changes in the most acute stage of development is the DWI regime. The DWI exceeds the value on FLAIR, which indicates greater information content on ADC maps. Conclusion. The developed improved protocol of MR examination of patients in the acute period of ischemic stroke makes it possible to identify the ischemic zone in a short time. The scan time is about 9 minutes, which is comparable to the time of a comprehensive CT scan, and taking into account the average patient’s 5-minute laying time, the relative differences in the «laying+scanning» CT and «laying+scanning» MRI time are only 30 %.