Magnetic resonance imaging for diagnostic workup of embolic stroke of undetermined source: A systematic review

Author:

Khenkina Natallia1ORCID,Aimo Alberto23,Fabiani Iacopo3,Masci Pier Giorgio4,Sagris Dimitrios5ORCID,Williams Steven E6,Mavraganis George7,Chen Hui-Sheng8ORCID,Wintermark Max9,Michel Patrik10ORCID,Ntaios George11,Georgiopoulos Georgios47

Affiliation:

1. Postgraduate School of Diagnostic and Interventional Radiology, University of Milan, Milan, Italy

2. Institute of Life Sciences, Scuola Superiore Sant’Anna, Pisa, Italy

3. Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy

4. School of Biomedical Engineering & Imaging Sciences, King’s College London, London, UK

5. Liverpool Centre of Cardiovascular Sciences, University of Liverpool, Liverpool, UK

6. The University of Edinburgh, Edinburgh, UK

7. Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece

8. Department of Neurology, General Hospital of Northern Theater Command, Shenyang, China

9. Department of Radiology, Stanford University, Stanford, CA, USA

10. Stroke Center, Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland

11. Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece

Abstract

Background: Embolic stroke of undetermined source (ESUS) refers to ischemic stroke where the underlying cause of thromboembolism cannot be found despite the recommended diagnostic workup. Unidentified source of emboli hinders clinical decision-making and patient management with detrimental consequences on long-term prognosis. The rapid development and versatility of magnetic resonance imaging (MRI) make it an appealing addition to the diagnostic routine of patients with ESUS for the assessment of potential vascular and cardiac embolic sources. Aims: To review the use of MRI in the identification of cardiac and vascular embolic sources in ESUS and to assess the reclassification value of MRI examinations added to the conventional workup of ESUS. Summary of review: We reviewed the use of cardiac and vascular MRI for the identification of a variety of embolic sources associated with ESUS, including atrial cardiomyopathy, left ventricular pathologies, and supracervical atherosclerosis in carotid and intracranial arteries and in distal thoracic aorta. The additional reclassification after MRI examinations added to the workup of patients with ESUS ranged from 6.1% to 82.3% and varied depending on the combination of imaging modalities. Conclusion: MRI techniques allow us to identify additional cardiac and vascular embolic sources and may further decrease the prevalence of patients with the diagnosis of ESUS.

Publisher

SAGE Publications

Subject

Neurology,Neurology (clinical)

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3