Reuters Health Information 2008. © 2008 Reuters Ltd.
NEW YORK (Reuters Health) May 28 – Three dimensional MRI using a 3 Tesla system appears to be reliable and more accurate than transesophageal echocardiography for revealing aortic high-risk plaques in acute stroke patients, German researchers report in the May issue of the Journal of Neurology, Neurosurgery, & Psychiatry.
"Three-D MRI," lead investigator Dr. Andreas Harloff told Reuters Health, "provided a high sensitivity for the detection of aortic high-risk sources of cerebral embolism."
It was demonstrated "that 3-D MRI is a promising tool for the detection of high-risk plaques in patients with undefined stroke etiology — cryptogenic stroke — despite extensive routine diagnostics including transesophageal echocardiography," he said.
Dr. Harloff and colleagues at University Hospital Freiburg used both methods to examine 74 acute stroke patients. MRI detected plaques in 50% of the patients compared with 31.1% of patients using echocardiography. The number of high-risk plaques detected by MRI was also substantially higher than that with echocardiography (74 versus 47, respectively).
In addition, MRI detected aortic high-risk sources of brain ischemia in 8 of 26 patients with cryptogenic stroke, which were not found during standard diagnostics.
Dr. Harloff pointed out: "The detection of additional aortic high-risk pathologies by 3D MRI has the potential to guide and thus improve the prevention of recurrent stroke."
Nevertheless, he and his colleagues conclude that "before this novel MRI technique can be generally recommended, its diagnostic value needs to be evaluated rigorously at various imaging sites."
In an accompanying editorial, Dr. Emmanuel Touze of Centre Hospitalier Sainte-Anne, Paris, agrees and concludes that: "Despite some limitations, the results of this work are important because they show the feasibility of the technique and give us new insights into what can be done in this field."
J Neurol Neurosurg Psychiatry 2008;79:489,540-546.