[Acute stroke imaging before IV thrombolysis: what modality of imaging for France in 2007?].
OBJECTIVE
To report the results of a radiological survey of the management of acute stroke prior to intravenous thrombolysis.


METHODS
A questionnaire on imaging as used in the management of stroke was sent to 80 stroke units across France at the beginning of 2007 and included the first imaging modality used (CT or MRI), the imaging protocol before treatment and the exclusion criteria followed for thrombolysis.


RESULTS
CT was most often used as the first modality for the management of acute stroke (by 70% of the 53 responding centers) and 26 centers (49%) used both CT and MRI. Only 12 centers (22%) routinely performed MRI to screen for acute stroke. However, more than half the patients who had received thrombolysis in 2006 had been examined using MRI. In fact, after three-hour poststroke, intravenous thrombolysis was predominantly decided upon from MRI data. The survey showed that imaging criteria are well standardized for CT, whereas they are more variable for MRI. Furthermore, the majority (28 of 38) of the centers considered that thrombolysis could be applied despite a clinical contraindication (such as unknown time of onset or convulsions) if MRI categorically diagnosed an acute stroke.


CONCLUSIONS
This survey showed that CT-based screening of acute stroke before thrombolysis remains the standard modality in France, with a consensus on decision-making criteria. The survey also revealed a change in imaging management, with a growing role for MRI as the first examination.
Klein
I
I
Service de radiologie, hôpital Bichat, CHU de Paris, 46, rue Henri-Huchard, 75018 Paris, France. isabelle.klein@bch.aphp.fr
Oppenheim
C
C
Leclerc
X
X
D000208:Acute Disease; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005602:France; D006801:Humans; D007262:Infusions, Intravenous; D008279:Magnetic Resonance Imaging; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D020521:Stroke / Q000175:diagnosis / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D015912:Thrombolytic Therapy / Q000379:methods*; D014057:Tomography, X-Ray Computed
D005343:Fibrinolytic Agents