Comparison of MRI and CT for detection of acute intracerebral hemorrhage
Comparison of MRI and CT for detection of acute intracerebral hemorrhage
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DOI：
10.1001/jama.292.15.1823
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发表时间：
2004-10-20
影响因子：
120.7
通讯作者：
Warach, S
中科院分区：
文献类型：
--
作者：
Kidwell, CS;Chalela, JA;Warach, S
背景非对比计算机断层扫描(CT)是对急性中风症状患者进行初步评估的标准脑成像研究。多模式磁共振成像(MRI)已被提议在急诊卒中环境中替代CT。目的比较MRI和CT在诊断急性局灶性卒中患者急性脑出血中的准确性。设计、环境和患者：2000年10月至2003年2月，在两个卒中中心(加州大学洛杉矶分校医学中心和马里兰州贝塞斯达郊区医院)进行了一项前瞻性多中心研究。对发病6小时内出现局灶性卒中症状的患者行头颅MRI和CT平扫。主要结果4位盲者一致认为急性脑出血和脑出血在梯度回波(GRE)MRI和CT扫描上被诊断为脑出血。结果在纳入200名患者后，研究提前结束，在一项计划外的中期分析时发现MRI正在检测CT未发现的出血性转化病例。对于出血的诊断，MRI阳性71例，CT阳性29例(P
Context Noncontrast computed tomography (CT) is the standard brain imaging study for the initial evaluation of patients with acute stroke symptoms. Multimodal magnetic resonance imaging (MRI) has been proposed as an alternative to CT in the emergency stroke setting. However, the accuracy of MRI relative to CT for the detection of hyperacute intracerebral hemorrhage has not been demonstrated.Objective To compare the accuracy of MRI and CT for detection of acute intracerebral hemorrhage in patients presenting with acute focal stroke symptoms.Design, Setting, and Patients A prospective, multicenter study was performed at 2 stroke centers (UCLA Medical Center and Suburban Hospital, Bethesda, Md), between October 2000 and February 2003. Patients presenting with focal stroke symptoms within 6 hours of onset underwent brain MRI followed by noncontrast CT.Main Outcome Measures Acute intracerebral hemorrhage and any intracerebral hemorrhage diagnosed on gradient recalled echo (GRE) MRI and CT scans by a consensus of 4 blinded readers.Results The study was stopped early, after 200 patients were enrolled, when it became apparent at the time of an unplanned interim analysis that MRI was detecting cases of hemorrhagic transformation not detected by CT. For the diagnosis of any hemorrhage, MRI was positive in 71 patients with CT positive in 29 (P