Hand P J, Wardlaw J M, Rowat A M, Haisma J A, Lindley R I, Dennis M S
Division of Clinical Neurosciences, Western General Hospital, Edinburgh EH4 2XU, UK.
J Neurol Neurosurg Psychiatry. 2005 Nov;76(11):1525-7. doi: 10.1136/jnnp.2005.062539.
To assess organisational and patient specific limitations and safety of magnetic resonance imaging (MRI) as the first line investigation for hospital admitted stroke patients.
Consecutive patients admitted with acute stroke were assessed and an attempt was made to perform MRI in all patients. Oxygen saturation and interventions required during scanning were recorded.
Among 136 patients recruited over 34 weeks, 85 (62%) underwent MRI. The patients' medical instability (15 of the 53 not scanned), contraindications to MRI (six of the 53 not scanned), and rapid symptom resolution (10 of the 53 not scanned) were the main reasons for not performing MRI. Of the 85 patients who underwent MRI, 26 required physical intervention, 17 did not complete scanning, and 11 of the 61 who had successful oxygen saturation monitoring were hypoxic during MRI. Organisational limitations accounted for only 13% of failures to scan.
Up to 85% of hospital admitted acute stroke patients could have MRI as first line imaging investigation, but medical instability is the major limitation. Hypoxia is frequent in MRI. Patients should be monitored carefully, possibly by an experienced clinician, during scanning.
评估磁共振成像（MRI）作为医院收治的中风患者一线检查手段时在组织及患者个体方面的局限性和安全性。
对连续收治的急性中风患者进行评估，并尝试对所有患者进行MRI检查。记录扫描过程中的血氧饱和度及所需干预措施。
在34周内招募的136例患者中，85例（62%）接受了MRI检查。患者病情不稳定（53例未扫描患者中的15例）、MRI检查禁忌证（53例未扫描患者中的6例）以及症状迅速缓解（53例未扫描患者中的10例）是未进行MRI检查的主要原因。在接受MRI检查的85例患者中，26例需要物理干预，17例未完成扫描，61例成功进行血氧饱和度监测的患者中有11例在MRI检查期间出现缺氧。组织方面的局限性仅占未进行扫描的13%。
高达85%的医院收治的急性中风患者可以将MRI作为一线影像学检查，但病情不稳定是主要限制因素。MRI检查期间缺氧情况常见。扫描过程中应仔细监测患者，可能需由经验丰富的临床医生进行监测。
