Magnetic resonance imaging criteria for thrombolysis in acute cerebral infarct

Niels Hjort, K. Butcher, S. M. Davis, C. S. Kidwell, W. J. Koroshetz, J. Röther, P. D. Schellinger, S. Warach, L. Østergaard

Research output: Contribution to journalArticle

193 Citations (Scopus)

Abstract

Background and Purpose - Magnetic resonance imaging (MRI) selection of stroke patients eligible for thrombolytic therapy is an emerging application. Although the efficacy of therapy within 3 hours after onset of symptoms with intravenous (IV) tissue plasminogen activator (tPA) has been proven for patients selected with computed tomography (CT), no randomized, double-blinded MRI trial has been published yet. Summary of Review - MRI screening of acute stroke patients before thrombolytic therapy is performed in some cerebrovascular centers. In contrast to the CT trials, MRI pilot studies demonstrate benefit of therapy up to 6 hours after onset of symptoms. This article reviews the literature that has lead to current controlled MRI-based thrombolysis trials. We examined the MRI criteria applied in 5 stroke centers. Along with the personal views of clinicians at these centers, the survey reveals a variety of clinical and MRI technical aspects that must be further investigated: the therapeutic consequence of microbleeds, the use of magnetic resonance angiography, dynamic time windows, and others. Conclusion - MRI is an established application in acute evaluation of stroke patients and may suit as a brain clock, replacing the currently used epidemiological time clock when deciding whether to initiate thrombolytic therapy. MRI criteria for thrombolytic therapy are applied in some cerebrovascular centers, but the results of ongoing clinical trials must be awaited before it is possible to reach consensus.

Original languageEnglish (US)
Pages (from-to)388-397
Number of pages10
JournalStroke
Volume36
Issue number2
DOIs
StatePublished - Feb 2005

Fingerprint

Magnetic Resonance Imaging
Thrombolytic Therapy
Stroke
Tomography
Magnetic Resonance Angiography
Tissue Plasminogen Activator
Patient Selection
Therapeutics
Clinical Trials
Brain

Keywords

  • Diffusion magnetic resonance imaging
  • Magnetic resonance imaging
  • Perfusion magnetic resonance imaging
  • Stroke management
  • Thrombolysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Neuroscience(all)

Cite this

Hjort, N., Butcher, K., Davis, S. M., Kidwell, C. S., Koroshetz, W. J., Röther, J., ... Østergaard, L. (2005). Magnetic resonance imaging criteria for thrombolysis in acute cerebral infarct. Stroke, 36(2), 388-397. https://doi.org/10.1161/01.STR.0000152268.47919.be

Magnetic resonance imaging criteria for thrombolysis in acute cerebral infarct. / Hjort, Niels; Butcher, K.; Davis, S. M.; Kidwell, C. S.; Koroshetz, W. J.; Röther, J.; Schellinger, P. D.; Warach, S.; Østergaard, L.

In: Stroke, Vol. 36, No. 2, 02.2005, p. 388-397.

Research output: Contribution to journalArticle

Hjort, N, Butcher, K, Davis, SM, Kidwell, CS, Koroshetz, WJ, Röther, J, Schellinger, PD, Warach, S & Østergaard, L 2005, 'Magnetic resonance imaging criteria for thrombolysis in acute cerebral infarct', Stroke, vol. 36, no. 2, pp. 388-397. https://doi.org/10.1161/01.STR.0000152268.47919.be
Hjort N, Butcher K, Davis SM, Kidwell CS, Koroshetz WJ, Röther J et al. Magnetic resonance imaging criteria for thrombolysis in acute cerebral infarct. Stroke. 2005 Feb;36(2):388-397. https://doi.org/10.1161/01.STR.0000152268.47919.be
Hjort, Niels ; Butcher, K. ; Davis, S. M. ; Kidwell, C. S. ; Koroshetz, W. J. ; Röther, J. ; Schellinger, P. D. ; Warach, S. ; Østergaard, L. / Magnetic resonance imaging criteria for thrombolysis in acute cerebral infarct. In: Stroke. 2005 ; Vol. 36, No. 2. pp. 388-397.
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