Computed tomography versus magnetic resonance imaging in the management of acute ischaemic stroke

ABSTRACT

To compare the appearance of acute infarets on CT versus MRI, 18 patients with acute ischaemic strokes were imaged by CT and MRI, both being performed within 3 days of the ictus. MRI and CT findings were equivocal in 4 cases. MRI showed acute infarets not detected on CT in 6 cases. MRI better delineated acute infarets than CT in 8 cases by showing that the cause of the stroke is a relatively large zone of infarct not just a lacune or a small zone in 3 cases, by showing acute infarets in more than one vascular territory when CT showed an infarct in only one vascular territory thus suggesting embolic disease in 2 cases, and by detecting a hemorrhagic component of the acute infarct not shown on CT in 3 cases. Our results confirm earlier reports that MRI better detects, delineates distribuion, extent, and components of acute infarets than CT thus providing information that affects patient's management. The impact of this on actual patient Management as well as future prospectives of MRI are discussed