Imaging
Stroke
- Preliminary Diagnosis: Stroke
-
I. What imaging technique is first-line for this diagnosis
- II. Describe the advantages and disadvantages of this technique for diagnosis of stroke.
-
III. What are the contraindications for the first-line imaging technique?
-
IV. What alternative imaging techniques are available?
- V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of stroke.
- VI. What are the contraindications for the alternative imaging techniques?
Preliminary Diagnosis: Stroke
I. What imaging technique is first-line for this diagnosis
Non-contrast CT of the brain.
II. Describe the advantages and disadvantages of this technique for diagnosis of stroke.
Advantages
Relatively fast, inexpensive imaging modality.
Highly specific and sensitive to evaluate and rule out intracranial hemorrhage.
Disadvantages
Exposes patients to ionizing radiation.
Less sensitive for detecting ischemia or infarction compared with MR imaging.
III. What are the contraindications for the first-line imaging technique?
CT imaging may be contraindicated in pregnant patients.
IV. What alternative imaging techniques are available?
Non-contrast MR of the brain (Stroke Protocol)
V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of stroke.
Non-contrast MR of the brain (Stroke Protocol)
Advantages
Imaging is more sensitive and specific in detecting early signs of ischemia and infarction.
Better able to distinguish chronicity of infarct than CT
Does not expose the patient to ionizing radiation.
Sensitive in detecting subtle microhemorrhage.
Disadvantages
Expensive
Time-consuming
Requires significant patient cooperation to minimize artifact
VI. What are the contraindications for the alternative imaging techniques?
Non-contrast MR of the brain (Stroke Protocol)
Contraindicated in patients with non-MR compatible hardware.
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