Comparative analysis of functional outcome for CT-based versus MRI-based evaluation in acute ischemic stroke prior to mechanical thrombectomy

Abstract

Background: This study aims to compare functional outcome for Computed tomography (CT)-based versus Magnetic resonance imaging (MRI)-based evaluation in acute ischemic stroke patients prior to Mechanical thrombectomy (MT) in less than 6-h window period in anterior circulation stroke. Participants were patients admitted from September 2, 2018 to September 2, 2020 with an acute ischemic stroke who underwent mechanical thrombectomy treatment. Total duration of MRI stroke protocol and CT scan with Computed tomography angiography (CTA) was 12 min 57 s, and 9 min 23 s, respectively. Follow-up for periodic Modified Rankin Scale (MRS) was performed at 3 months. Results: Number of patients included in the study were 152 with mean age of 54.6 (range 22–80) years with male predominance (n = 102). Mean GCS on admission was 12 (4–15) and 13(4–14) in CT and MRI group, respectively. National Institute of Health stroke scale (NIHSS) on admission was 17 (4–30) and 16(4–30) and at discharge was 7 (2–23) and 6(2–22) in CT-based group and MRI-based group, respectively. In the MRI group 65.5% had good outcome with mRS (0–2) at 3-month follow-up compared to 35.51% in CT group. Conclusion: The current standard neuroimaging in acute ischemic stroke patients is CT and CTA brain. Using MRI over CT scan for acute ischemic stroke may improve clinical outcomes for the subgroup of patients who have an unclear diagnosis and who have higher risk of complications with MT. Even though MRI and MRA take longer period to acquire, patient’s clinical outcome was better in MRI group in comparison to CT group and was comparable to that of the five major endovascular trials.