title: Audit of a policy of magnetic resonance imaging with diffusion-weighted imaging as first-line neuroimaging for in-patients with clinically suspected acute stroke.
abstract: OBJECTIVE
  To audit the feasibility and use of diffusion-weighted (DW) magnetic resonance imaging (MRI) as initial neuroimaging for in-patients with clinically suspected acute stroke.
  
  
  METHODS
  In April 2000, MRI with DW and T2-weighted sequence was locally instituted as initial neuroimaging for patients with clinically suspected acute stroke. This retrospective study reviewed imaging performed for in-patients with suspected acute stroke over a 9-month period. Data were collected on image type, result and need for repeat imaging.
  
  
  RESULTS
  During the study period, 124 patients had neuroimaging for suspected cerebrovascular accident, and 119 were MRI safe. Eighty-eight (73.9%) patients underwent DW MRI as first-line investigation. Five patients were not MRI safe and 31 had computed tomography (CT) as first-line imaging due to lack of available MRI capacity. Repeat neuroimaging was performed in 16 (12.9%) patients. Study times were comparable for both types of neuroimaging: a mean of 13 min for MRI and 11 min for CT.
  
  
  CONCLUSIONS
  The audit standard was achieved in 88 (73.9%) patients. The use of DW MRI as a first-line investigation for patients with a clinical diagnosis of acute stroke is achievable in a district general hospital setting.
authors.affiliation: Department of Radiology, Stoke Mandeville Hospital, Aylesbury, UK.
authors.forename: B T
authors.initials: BT
authors.lastname: Buckley
authors.forename: A
authors.initials: A
authors.lastname: Wainwright
authors.forename: T
authors.initials: T
authors.lastname: Meagher
authors.forename: D
authors.initials: D
authors.lastname: Briley
mesh_terms: D003657:Decision Making; D005240:Feasibility Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008485:Medical Audit; D020521:Stroke / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000592:standards; D016526:Workload