Acute MRI in Transient Ischemic Attack

Ischemic Attack, Transient Clinical Trial

Official title:

Acute MRI-techniques for the Detection of Ischemic Lesions After Transient Ischemic Attack

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01531946
• Other study ID #: H-1-2011-75
• Status: Completed
• Start date: January 2012
• Est. completion date: May 2017

Study information

• Verified date: January 2021
• Source: Bispebjerg Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

The purpose of this study is to detect acute ischemic lesions in patients admitted with symptoms of transient ischemic attack (TIA).

Diffusion weighted Imaging (DWI) is today one of the best ways to detect ischemic lesions after TIA. The problem is that this only gives the diagnosis in 30% of the cases.

It is possible that the addition of Arterial spin labeling (ASL) perfusion imaging and diffusion tensor imaging will make it possible to give a more accurate diagnosis.

Description:

The purpose of this study is to detect acute ischemic lesions in patients admitted with symptoms of transient ischemic attack (TIA).

Diffusion weighted Imaging (DWI) is today one of the best ways to detect ischemic lesions after TIA. The problem is that this only gives the diagnosis in 30% of the cases.

It is possible that the addition of ASL-perfusion imaging and diffusion tensor imaging will make it possible to give a more accurate and selective diagnosis of TIA.

Patients admitted with clinical signs of TIA can be included. Patients will be examined with the TIA protocol in reference to the standardized clinical care:

1. 1,5 tesla gradient echo and 3 tesla Susceptibility weighted imaging (SWI) to detect microbleed as sign of small vessel disease.

2. Axial T2 FLAIR to detect white matter lesions.

3. Axial DWI to detect areas with impeded diffusion.

(Total scantime 10min)

If no signs of ischemic lesions is detected the following additional research scan-protocol will be initiated:

1. Perfusion without contrast: Arterial spin labeling (ASL) with the ability of showing signs of ischemia.

2. Diffusion tensor imaging (DTI): Has a higher sensitivity than DWI in displaying local ischemic lesions.

(Total additional scantime 10min)

All in All 20min in the scanner.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 199
• Est. completion date: May 2017
• Est. primary completion date: May 2017
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Clinical signs of TIA

• Informed consent

• No serious respiratory or cardiac implications

Exclusion Criteria:

• Contraindications to MRI

Related Conditions & MeSH terms

• Ischemia
• Ischemic Attack, Transient

Intervention

Procedure:
• MRI Scan
Patients will have to spend additional 10min in the scanner. Additional scan modalities used: Perfusion without contrast: Arterial spin labeling (ASL) with the ability of showing signs of ischemia. Diffusion tensor imaging (DTI): Has a higher sensitivity than DWI in displaying local ischemic lesions. An overall 20min scan period.

Locations

Country	Name	City	State
Denmark	Bispebjerg Hospital	Copenhagen	Capital Region

Sponsors (1)

Lead Sponsor	Collaborator
Bispebjerg Hospital

Country where clinical trial is conducted

Denmark, 

References & Publications (3)

Luengo-Fernandez R, Gray AM, Rothwell PM. Effect of urgent treatment for transient ischaemic attack and minor stroke on disability and hospital costs (EXPRESS study): a prospective population-based sequential comparison. Lancet Neurol. 2009 Mar;8(3):235-43. doi: 10.1016/S1474-4422(09)70019-5. Epub 2009 Feb 4. — View Citation

Olivot JM, Albers GW. Diffusion-perfusion MRI for triaging transient ischemic attack and acute cerebrovascular syndromes. Curr Opin Neurol. 2011 Feb;24(1):44-9. doi: 10.1097/WCO.0b013e328341f8a5. Review. — View Citation

Schaefer PW, Copen WA, Lev MH, Gonzalez RG. Diffusion-weighted imaging in acute stroke. Magn Reson Imaging Clin N Am. 2006 May;14(2):141-68. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	frequency of patients with ischaemic lessions on DTI	We want to assess the frequency of patients in whom a diffusion restricted lesion can only be observed on DTI	on first MRI