on contrast-enhanced short-time MRI and conventional CT: Comparison of diagnostic parameters in patients with acute neurological symptoms

Not Applicable

• Conditions: I67.88; I63.0; R58; Cerebral infarction due to thrombosis of precerebral arteries; Haemorrhage, not elsewhere classified

• Registration Number: DRKS00013356
• Lead Sponsor: Klinikum der Universität München, Campus Großhadern

Brief Summary

Results: Ninety-three additional intracranial lesions (acute ischemia, n = 21; intracranial hemorrhage/microbleeds, n = 27; edema, n = 2; white matter lesion, n = 38; chronic infarction, n = 3; others, n = 2) were detected by ultrafast-MRI, whereas 101 additional intracranial lesions were detected by the standard-length protocol (acute ischemia, n = 24; intracranial hemorrhage/microbleeds, n = 32; edema, n = 2; white matter lesion, n = 38; chronic infarction, n = 3; others, n = 2). Image quality was equivalent to the standard-length protocol. Ultrafast-MRI demonstrated high diagnostic accuracy (sensitivity, 0.939 [0.881-0.972]; specificity, 1.000 [0.895-1.000]) for the detection of intracranial pathologies. MRI led to a change in patient management in 10% compared with the initial CT. Conclusions: Ultrafast-MRI enables time-optimized diagnostic workup in acute neurological emergencies at high sensitivity and specificity compared with a standard-length protocol, with direct impact on patient management. Ultrafast MRI protocols are a powerful tool in the emergency setting and may be implemented on various scanner types based on the optimization of individual acquisition parameters.

Detailed Description

Not available

Study Timeline

• Study Start: 2017-12-01
• Study Completion: 2019-01-30
• Results First Posted: 2020-03-01
• Last Update Posted: 19 August 2024

Recruitment & Eligibility

• Status: Complete
• Sex: All
• Target Recruitment: 150

Inclusion Criteria

patients of the emergency department of the Ludwig-Maximilians-University (LMU) Munich-Großhadern (minimum age 18 years)
- suspected intracranial pathologies (hemorrhage, ischemia, tumor, signs of inflammation, edema, increased intracranial pressure (ICP))
- insufficient explanation of symptoms after examination using the cranial computed tomography

Exclusion Criteria

- patients with MRI-incompatible intracorporeal material (e.g. pacemaker, bladder pacemaker, nerve stimulators)
- lacking capability of giving consent
- minors
- claustrophobia
- unstable general condition
- pregnancy
- sufficient explanation of symptoms by the cranial computed tomography

Study & Design

• Study Type: interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
The primary outcome of this study will be accomplished after the examination results have been assessed by a specialist and the sensitivities and specificities of the CT examination, accelerated MRI protocol and standard MRI protocol have been determined. The sensitivities and specificities of the CT examination, accelerated MRI protocol and standard MRI protocol (reference standard) will be compared and evaluated. We assume that the results of the standard and accelerated protocols will be virtually identical and the accelerated protocol will prove to be superior to CT.

Secondary Outcome Measures

Name	Time	Method
Two blinded, independent readers will analyze all pseudonymised records. All pathologies/observations detected in the accelerated and standard MRI protocols will be recorded. Additionally, examination quality of the accelerated and standard MRI protocols will be assessed analogous to Prakkamukal et al. (J Neuroimaging 2016;26:503-510) (1 - nondiagnostic, 2 - poor image quality and substantial artifacts, 3 - satisfactory, 4 - good image quality and minor artifacts, 5 - excellent image quality without artifacts). Gray-white matter differentiation will also be assessed analogous to Prakkamukal et al. (0 – no visible gray-white matter differentiation, 1 - unclear but recognizable borders, 2 - clear differentiation).