Diagnosis of Acute Ischemic Stroke by CT scan and Diffusion Weighted MRI

doi:https://doi.org/10.5281/zenodo.14550628

International Journal of Medical and Pharmaceutical Research

2024, Volume-5, Issue-6 doi: https://doi.org/10.5281/zenodo.14550628

Original Research Article

Diagnosis of Acute Ischemic Stroke by CT scan and Diffusion Weighted MRI

Md. Nazrul Islam Mollah , A. K. M. Anowar Hossain , Mohammad Ali Kabir , Zereen Sultana Deepa ,A. K. Al Miraj, Md. Helal Uddin Bhuiyan

DOI : https://doi.org/10.5281/zenodo.14550628

Published

Dec. 24, 2024

Abstract

Background: Acute ischemic stroke is the leading cause of death and disability. An accurate and practical understanding of imaging modalities is essential for the management of the acute stroke patients. Due to its widespread availability and speed, unenhanced Computed Tomography (CT) scan remains the initial study of choice for evaluating an acute stroke patients and Diffusion Weighted Magnetic Resonance Imaging (DWMRI) can detect abnormalities due to ischemia within 3 to 30 minutes of onset, when conventional MRI and CT images would still appear normal.Objective: To compare the diagnostic role of CT scan and DWMRI in acute ischemic stroke and establish the agreement between them.Methods: This cross-sectional study was performed on 110 patients from the Department of Radiology and Imaging, BSM Medical University Hospital, Dhaka, Bangladesh from July 2023 to August 2024. Patients were immediately transferred to the Department of Radiology and Imaging where they underwent comprehensive CT scans. Suspicion of acute ischemic stroke was present.Results: Total 110 patients were enrolled in this study. Almost one third (32.7%) patients belonged to age ≥70 years. The mean age was 61.11±12.49 years with range from 32 to 90 years. Almost two third patients were male (60%) followed by (40%) female. More than (38.2%) patients were retired from job, followed by house wife (34.5%). It was observed that 20 (20%) patients experienced headache, (32.7%) vertigo, (49.1%) vomiting, (70.9%) hemiparesis/hemiplegia, Majority (81.8%) had speech disturbance. The location of infarct showed that (23.6%) patients were in M1 segment (anterior circulation ASPECTS) followed by 52 (47.3%) in lentiform nucleus and 52 (47.3%) in internal capsule. Mass Effect were observed in both CT and DWMRI in 14 (12.7%) cases. More than (76.4%) patients showed parenchymal hypoattenuation (CT) and diffusion restriction (MRI) [CT, 76.4% and DWMRI, 78.2%]. Regarding ADC value, it was observed that majority (74.5%) patients were below 0.6X10-3 mm2/s. The agreement analysis of the two modalities (parenchymal hypoattenuation (CT) with diffusion restriction (MRI)) was found showing a Kappa value of 0.858 and p value <0.01. Conclusion: DWI-MRI is a better imaging method in detecting early ischemic lesions in acute ischemic stroke patients.

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