Brain MRI in Stroke

An introduction to brain MR imaging of stroke, including a discussion on how strokes occur, the goals of imaging, a review of standard brain MR sequences, MR angiography, and a review of several different stroke cases.
00:00 - Introduction
00:30 - Ischemic Strokes
02:58 - Hemorrhagic Strokes
04:00 - Goals of Stroke Imaging
05:04 - Head CT vs Brain MRI
07:32 - Brain MRI Sequences
15:00 - MR Angiography
17:52 - Example Cases

[@nikonikovic5844]

Great video, thank you very much!
Can you please link a publication, where we can find that specificity and sensitivity for CT detection of acute stroke? Thanks

[@radiologyframeworks]

Thanks!
You'll encounter a range of performance reported throughout the medical literature, and the reference I used was one that seemed closest to my personal observations over the years. The reference is: "CT and diffusion-weighted MR imaging in randomized order: diffusion-weighted imaging results in higher accuracy and lower interrater variability in the diagnosis of hyperacute ischemic stroke" by Fiebach et al. in Stroke (2002).
A reference that reported lower sensitivity, but higher specificity is "Certainty of Stroke Diagnosis: Incremental Benefit with CT Perfusion over Non-contrast CT and CT Angiography" by Hopyan et al. in Radiology (2010), where a sensitivity of 52.5% and specificity of 84.4% are reported for radiologists diagnosing stroke on non-contrast head CT.
There's another reference that reports even lower sensitivity and higher specificity for non-contrast head CT: "Magnetic resonance imaging and computed tomography in emergency assessment of patients with suspected acute stroke: a prospective comparison" by Chalela et al. in The Lancet (2007), where they report:
For acute stroke:
- CT sensitivity 26%
- MR sensitivity 83%
- CT specificity 98%
- MR specificity 97%
For acute ischemic stroke:
- CT sensitivity 16%
- MR sensitivity 83%
- CT specificity 98%
- MR specificity 96%