How much would performing diffusion-weighted imaging for all transient ischemic attacks increase MRI utilization?

Opeolu Adeoye, Laura Heitsch, Charles J. Moomaw, Kathleen Alwell, Jane Khoury, Daniel Woo, Matthew L. Flaherty, Simona Ferioli, Pooja Khatri, Joseph P. Broderick, Brett M. Kissela, Dawn Kleindorfer

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

OBJECTIVES-: The American Heart Association recently redefined TIA to exclude patients with infarction on neuroimaging. Given its advantages, MRI/diffusion-weighted imaging (DWI) was recommended as the preferred imaging modality. We determined how frequently MRI/DWI was performed for TIA and ascertained the proportion of clinically defined TIA patients who had ischemic lesions on DWI in our community in 2005. Methods-: All clinically defined TIA cases among residents of a 5-county region around Cincinnati who presented to emergency departments were identified during 2005. Demographics and medical history, whether MRI/DWI was performed, and DWI findings were recorded. Generalized estimating equations were used to compare groups to account for the design of the study and multiple events per patient. Results-: Of 834 TIA events in 799 patients, 323 events (40%) had MRI/DWI performed. Patients who had MRI/DWI were younger (mean, 66 vs 70 years; P=0.03), had less severe prestroke disability (baseline modified Rankin Scale score, 0; 44% vs 34%; P=0.02), were less likely to have previous stroke or TIA (42% vs 56%; P=0.002), and were less likely to have atrial fibrillation (10% vs 16%; P=0.01). Of the 323 events with DWI, 51 (15%) had evidence of acute infarction. Patients with positive DWI were older (75 vs 64 years; P=0.0001) and more likely to have atrial fibrillation (21% vs 7%; P=0.002). Conclusion-: Performing MRI/DWI on all clinically defined TIA patients in our community would reveal more cases of actual infarction but would more than double current use. Future studies should assess whether MRI/DWI is warranted for all TIA patients.

Original languageEnglish
Pages (from-to)2218-2222
Number of pages5
JournalStroke
Volume41
Issue number10
DOIs
StatePublished - Oct 2010

Keywords

  • magnetic resonance imaging
  • transient ischemic attack

Fingerprint Dive into the research topics of 'How much would performing diffusion-weighted imaging for all transient ischemic attacks increase MRI utilization?'. Together they form a unique fingerprint.

  • Cite this

    Adeoye, O., Heitsch, L., Moomaw, C. J., Alwell, K., Khoury, J., Woo, D., Flaherty, M. L., Ferioli, S., Khatri, P., Broderick, J. P., Kissela, B. M., & Kleindorfer, D. (2010). How much would performing diffusion-weighted imaging for all transient ischemic attacks increase MRI utilization? Stroke, 41(10), 2218-2222. https://doi.org/10.1161/STROKEAHA.110.592675