DWI, NCCT, Stroke
Background: Cerebrovascular stroke are second major cause of mortality and morbidity after ischemic heart diseases in adults. Diagnosis of stroke is critical for guiding management of patient, time is crucial in diagnosis, if diagnosis is done and management started within golden period of 3 to 4.5 hours it will dramatically changes the prognosis as well as post stroke morbidity.
Material and Methods: This study is prospective cross sectional study of sample size 100 subjects with an objective of Comparison of imaging findings in conventional CT (NCCT head) with DWI sequence of MRI brain in detection of hyper-acute and acute cerebral ischemia and its correlation with NIHSS scale on the basis of ASPECTS.
Results: The mean CT-MCA ASPECTS score is 9.29 and the mean MRI DWI- MCA ASPECTS score is 6.77. The mean CT-PCA ASPECTS score is 9.96 and the mean MRI DWI- PCA ASPECTS score is 9.27. The concordance between CT MCA-ASPECTS and MRI DWI- MCA ASPECTS scores is low. The concordance between CT PCA-ASPECTS and MRI DWI- PCA ASPECTS scores is very low. Apparent ischemia in territory of MCA was detected in 73 patients (73%) by DWI sequence of MRI, but in only 25 patients (25%) by CT. Apparent ischemia in territory of PCA was detected in 29 patients (29%) by DWI sequence of MRI, but in only 03 patients (3%) by NCCT. The number of patients with ischemia detected by DWI sequence of MRI was significantly higher than for CT. Overall, the sensitivity of CT was extremely low compared with that of DWI sequence of MRI.
Conclusion: Stroke was better detected by DWI sequence of MRI. Disadvantage of MRI is that it takes longer time to scan, however only DWI sequence take less than 5 minutes. Advantage of CT is that its scan time is less than 1 minute and it detects hemorrhages easily. Disadvantages of CT are radiation dose and it is not able to detect changes of acute stroke in initial hours.
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