ABSTRACT NUMBER: ESOC2026A743 DIAGNOSTIC SENSETIVITY OF CT HEAD VERSUS MRI HEAD AFTER BRIEF ISCHAEMIC NEUROLOGICAL SYMPTOMS :IMPLICATIONS FOR TIA PATHWAYS

Abstract Background and aims Non contrast CT head remains the first line neuroimage modality in suspected transient ischaemic attach TIA . Primarily to exclude intracranial haemorrhge. Nevertheles, its sensitivity for detecting ischaemic injury following brief neurological symptoms remains limited particularly when symptomes resolved rapidly. Aims, to evaluate the diagnostic sensitivity of CT imaging compaired with MRI namely (DWI) in patients presenting with short duration ischaemic symptoms (=15 minutes). Methods A prospective comparative imageing cohorts and guideline-supported evidances in evaluating CT and MRI head performances in suspected TIA at our local TIA centre for 324 patients over period of 6 months in 2025. Results A total of 324 patient who attended to our local TIA clinic during period between January 2025 and end of June 2025 . a 92 patient has been considerd for our prospective comparative imageing cohorts in adherance with our local guideline. Of those 92 patient suspected TIA , there was 46 patients who gave history of neurological symptoms over approximatly 15 minutes. CT head demonstrates poor sensitivity ( around 15% (approximately 7 patient) for detecting acute ischemic lesion in TIA . Nevertheless , MRI head with DWI sequence detects acute ischaemic changes in approximately 40:42 of TIA cases (approximately 95%). Conclusions In patients presented with brief ischemic neuroligical symptoms lasting approximately 15 min non contrast CT scan head has low sensitivity. MRI head with DWI of minimum basic sequences offers superior detection of ischemic injury and directly impact management. MRI head should therefor be recommended whenever clinically feasible. Conflict of interest Dr Aktham Elrekaby . nothing to disclose Dr Mustafa Al-shahni . nothing to disclose Rana Ismael Ali. nothing to disclose