Acute neuromedical and neurosurgical admissions. Standard and ultrafast MR imaging of the brain compared with cranial CT.
OBJECTIVE
To evaluate the role of standard and ultrafast MR brain imaging and compare the information with CT.


METHODS
This was a prospective study of 114 patients with acute neurological symptoms and signs. CT brain examinations consisted of axial non-enhanced images. MR imaging consisted of standard spin-echo/fast spin-echo sequences and a series of rapid techniques including echoplanar and single shot fast spin-echo sequences.


RESULTS
Using standard MR methods, 41% of the patients had all five sequences of good technical quality, while using ultrafast methods 81% of the patients had good technical quality examinations in all five sequences. In 3% of the cases, ischaemic stroke was incorrectly reported on CT. In 24% of the cases, MR gave extra diagnostic information not reported on CT and in a further 8%, one neuroradiologist reported the abnormality in agreement with the MR, whilst the other neuroradiologist reported the CT as normal. In 2 cases, subarachnoid haemorrhage was missed on MR. Subarachnoid haemorrhage was not shown on the ultrafast sequences.


CONCLUSIONS
MR can be used to image acute neurological admissions with a high success rate, particularly using ultrafast methods. In many cases, MR provided extra information of direct clinical relevance not shown on CT.
Griffiths
P D
PD
Section of Academic Radiology, University of Sheffield, and Hallamshire Hospital, UK.
Wilkinson
I D
ID
Patel
M C
MC
Romanowski
C A
CA
Mitchell
P
P
Graham
A
A
Powell
T
T
Hodgson
T J
TJ
Paley
M N
MN
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001927:Brain Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002545:Brain Ischemia / Q000175:diagnosis / Q000000981:diagnostic imaging; D002648:Child; D003937:Diagnosis, Differential; D017352:Echo-Planar Imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D015588:Observer Variation; D010343:Patient Admission; D011446:Prospective Studies; D020521:Stroke / Q000175:diagnosis / Q000000981:diagnostic imaging; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed