Acute neuromedical and neurosurgical admissions - Standard and ultrafast MR imaging of the brain compared with cranial CT

Purpose: To evaluate the role of standard and ultrafast MR brain imaging an d compare the information with CT. Material and Method's: This was a prospective study of 114 patients with ac ute neurological symptoms and signs. CT brain examinations consisted of axi al non-enhanced images. MR imaging consisted of standard spin-echo/fast spi n-echo sequences and a series of rapid techniques including echoplanar and single shot fast spin-echo sequences. Results: Using standard MR methods, 41% of the patients had all five sequen ces of good technical quality, while using ultrafast methods 81% of the pat ients had good technical quality examinations in all five sequences. In 3% of the cases, ischaemic stroke was incorrectly reported on CT. In 24% of th e cases, MR gave extra diagnostic information not reported on CT and in a f urther 8%, one neuroradiologist reported the abnormality in agreement with the MR, whilst the other neuroradiologist reported the CT as normal. In 2 c ases, subarachnoid haemorrhage was missed on MR. Subarachnoid haemorrhage w as not shown on the ultrafast sequences. Conclusion: MR can be used to image acute neurological admissions with a hi gh success rate, particularly using ultrafast methods. In many cases, MR pr ovided extra information of direct clinical relevance not shown on CT.