scholarly journals Cost Analysis of the Addition of Hyperacute Magnetic Resonance Imaging for Selection of Patients for Endovascular Stroke Therapy

2017 ◽  
Vol 6 (3-4) ◽  
pp. 183-190 ◽  
Author(s):  
Seby John ◽  
Nicolas R. Thompson ◽  
Terry Lesko ◽  
Nancy Papesh ◽  
Nancy Obuchowski ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Direct Costs ◽  
Stroke Therapy ◽  
Resonance Imaging ◽  
Mri Protocol ◽  
Selection Of Patients ◽  
Selection Of ◽  
Endovascular Stroke Therapy

Background and Purpose: Patient selection is important to determine the best candidates for endovascular stroke therapy. In application of a hyperacute magnetic resonance imaging (MRI) protocol for patient selection, we have shown decreased utilization with improved outcomes. A cost analysis comparing the pre- and post-MRI protocol time periods was performed to determine if the previous findings translated into cost opportunities. Materials and Methods: We retrospectively identified individuals considered for endovascular stroke therapy from January 2008 to August 2012 who were ≤8 h from stroke symptoms onset. Patients prior to April 30, 2010 were selected based on results of the computed tomography/computed tomography angiography alone (pre-hyperacute), whereas patients after April 30, 2010 were selected based on results of MRI (post-hyperacute MRI). Demographic, outcome, and financial information was collected. Log-transformed average daily direct costs were regressed on time period. The regression model included demographic and clinical covariates as potential confounders. Multiple imputation was used to account for missing data. Results: We identified 267 patients in our database (88 patients in pre-hyperacute MRI period, 179 in hyperacute MRI protocol period). Patient length of stay was not significantly different in the hyperacute MRI protocol period as compared to the pre-hyperacute MRI period (10.6 vs. 9.9 days, p < 0.42). The median of average daily direct costs was reduced by 24.5% (95% confidence interval 14.1-33.7%, p < 0.001). Conclusions: Use of the hyperacute MRI protocol translated into reduced costs, in addition to reduced utilization and better outcomes. MRI selection of patients is an effective strategy, both for patients and hospital systems.

scholarly journals Magnetic resonance imaging in the assessment of acute stroke

2021 ◽  
Vol 12 (1) ◽  
pp. 12-19
Author(s):  
Majda Handanović ◽  
Fuad Julardžija ◽  
Adnan Šehić ◽  
Amela Sofić ◽  
Merim Jusufbegović ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Ischemic Stroke ◽  
Magnetic Resonance ◽  
Acute Stroke ◽  
Mri Imaging ◽  
Resonance Imaging ◽  
Imaging Protocols ◽  
Stroke Diagnosis ◽  
Selection Of Patients ◽  
Selection Of

Introduction: Stroke is the second leading underlying cause of death globally and the leading cause of disability in adults. Stroke diagnosis should be performed quickly and efficiently to eliminate other potential causes of neurological deficits and to assess the time since the onset of clinical symptoms. Computed tomography (CT) and magnetic resonance imaging (MRI) are essential methods of detecting and evaluating stroke type and treatmentoptions. Diffusion and perfusion MR imaging is recommended for early stroke diagnosis, as well as for the selection of patients for recanalization therapy, and is considered effective in assessing treatment outcomes. The objectives of this study were to demonstrate the diagnostic value of diffusion and perfusion imaging in the diagnosis of acute ischemic stroke, analyze the role of magnetic resonance imaging in the selection of patients with acute stroke for recanalization therapy, and assess the effect of acute stroke complicity.Material and methods: The research is designed as a systematic review of the primary scientific research literature, which was published in English in relevant scientific databases (PubMed, Google Scholar, Medline) from 2014 to 2021.Results: 14 scientific research papers were singled out and the general characteristics of the study were analyzed (country, authors, year of publication, title of the study, type of study, study objectives, research methods, results and conclusion). A quality assessment of the included studies with cohort design and randomized controlled studies was performed, and most belong to the category of high-quality studies with a smaller number of medium-quality studies. The overall percentage of detected AIS cases in isolated studies using the DWI and/or PWI sequence was 90.8%. At the same time, the outcome of recanalization therapy was assessed using MRI studies (the number of patients who developed adverse events with functional data outcome 30 or 90 days after the procedure was observed). Comparison of MRI and CT imaging protocols provided data on the total percentage of detected acute stroke cases using CT imaging protocols (68.9%) and MRI imaging protocols (88.5%), which is why MRI is considered a superior method.Conclusion: Although CT is a suitable method for visualizing bleeding and also for early differentiation of hemorrhagic from ischemic stroke, if MRI imaging is available, it is recommended to use DWI, PWI, MRA sequences for a more accurate diagnosis of stroke in the acute phase.

scholarly journals Comparison of Magnetic Resonance Imaging Mismatch Criteria to Select Patients for Endovascular Stroke Therapy

Stroke ◽  
2014 ◽  
Vol 45 (5) ◽  
pp. 1369-1374 ◽  
Author(s):  
Nishant K. Mishra ◽  
Gregory W. Albers ◽  
Søren Christensen ◽  
Michael Marks ◽  
Scott Hamilton ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Stroke Therapy ◽  
Resonance Imaging ◽  
Endovascular Stroke Therapy

Bildgebende Diagnostik des Innenohrs vor Cochleaimplantation

2020 ◽  
Vol 99 (03) ◽  
pp. 181-191
Author(s):  
Martin G. Mack ◽  
Markus M. Suckfüll
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Cochlear Implant ◽  
Hearing Aids ◽  
Preoperative Evaluation ◽  
Bildgebende Diagnostik ◽  
Speech Understanding ◽  
Resonance Imaging ◽  
Selection Of

AbstractIf sufficient speech understanding can no longer be achieved with conventional hearing aids, the indication for a cochlear implant is very often present. Imaging plays an important preoperative role, as it is the only way to decide whether a cochlear implant is possible or not. The preoperative evaluation of the temporal bone for the precise selection of the candidates for cochlear implant is including CT (Computed Tomography) and MRI (Magnetic Resonance Imaging).

scholarly journals Magnetic Resonance Imaging Selection for Endovascular Stroke Therapy

Stroke ◽  
2018 ◽  
Vol 49 (6) ◽  
pp. 1402-1406 ◽  
Author(s):  
Claus Z. Simonsen ◽  
Albert J. Yoo ◽  
Mads Rasmussen ◽  
Kristina E. Sørensen ◽  
Thabele Leslie-Mazwi ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Stroke Therapy ◽  
Resonance Imaging ◽  
Selection For ◽  
Endovascular Stroke Therapy
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