Abstract

*Dr. Thamanna M.D., Dr. Akshay Deepak and Dr. Deepak Arjundas

ABSTRACT

Background: MRI is an important tool for early diagnosis, prognosis, and treatment of acute ischemic stroke. This study assesses the effects of MRI parameters on stroke diagnosis, functional outcome, and treatment. Methods: 200 patients with acute ischemic stroke were subjected to MRI, through diffusion-weighted imaging (DWI), fluid-attenuated inversion recovery (FLAIR), susceptibility-weighted imaging (SWI), magnetic resonance angiography (MRA), and magnetic resonance venography (MRV). MRI results were compared with clinical outcomes using modified Rankin Scale (mRS) and National Institutes of Health Stroke Scale (NIHSS). Variations in MRI parameters and their effects on treatment choices were evaluated. Results: Positive DWI lesions were noted in 83.5% of patients, with cortical infarcts being the most frequent (48.5%). On presentation, the mean volume of DWI lesions was 45.3 ± 22.7 ml, which was significantly reduced to 28.4 ± 18.6 ml on discharge (p < 0.0001). The percentage of patients with FLAIR positivity was raised from 67% to 79% (p = 0.0069). Hemorrhagic transformation on SWI identified fell from 13% to 10.5% (p = 0.4381). MRV abnormalities at presentation were identified in 8%, falling to 5.5% on discharge (p = 0.3196). DWI lesion volume and mRS outcomes were strongly correlated (r = 0.86, p < 0.001). MRI results directed treatment, where 41% of patients had thrombolysis and 13.5% had thrombectomy. A noteworthy decrease in NIHSS scores was observed on discharge (p < 0.001). Conclusion: MRI-based assessment of acute ischemic stroke yields essential information on infarct patterns, progression of the lesion, and effectiveness of treatment.