CT versus MRI in acute stroke

There is a new article in Stroke, that compares non-contrast CT, perfusion CT and CT angiography versus diffusion and perfusion MRI, in patients presenting with stroke within the first 6 hours. It shows that this combination on CT is an acceptable method for analysing acute and hyperacute stroke and can replace MRI when MRI is not available.

With the growth of multi-slice CTs and the more read availability of CT over MRI in our country, as well as the fast nature of the study, this approach may make much more sense.

In an accompany comment, Rudiger von Kummer analyses this article and makes a very interesting comment. "A normal CT excludes major ischemic damage with high specificity7 and thus allows reperfusion therapy – in my personal experience – even beyond accepted time windows". This is yet not a practice that we follow, but may have an impact on management if this is proved to be scientifically accurate.