Clinical trial NCT01531946: Acute MRI in Transient Ischemic Attack
Official title: Acute MRI-techniques for the Detection of Ischemic Lesions After Transient Ischemic Attack
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Ischemic Attack, Transient
Keywords: Diffusion Tensor Imaging
Lead sponsor: Bispebjerg Hospital
Sponsor class: OTHER
First posted: 2012-02-13
Enrollment: 199
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_ONLY
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients admitted to the stroke ward at Bispebjerg University Hospital with signs of TIA.

Brief 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.

Detailed 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.

Eligibility criteria: Inclusion Criteria:

* Clinical signs of TIA
* Informed consent
* No serious respiratory or cardiac implications

Exclusion Criteria:

* Contraindications to MRI

Primary outcomes:
measure: frequency of patients with ischaemic lessions on DTI
timeFrame: on first MRI
Secondary outcomes:
Other outcomes:
Locations:
city: Copenhagen
country: Denmark
facility: Bispebjerg Hospital
state: Capital Region
Study officials:
affiliation: Department of Neurology and Cerebrovascular Diseases, Bispebjerg Hospital
name: Hanne Christensen, MD, DMSci
role: PRINCIPAL_INVESTIGATOR
References:
citation: 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.
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.
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. doi: 10.1016/j.mric.2006.06.005.
citation: Havsteen I, Willer L, Ovesen C, Nybing JD, AEgidius K, Marstrand J, Meden P, Rosenbaum S, Folke MN, Christensen H, Christensen A. Significance of arterial spin labeling perfusion and susceptibility weighted imaging changes in patients with transient ischemic attack: a prospective cohort study. BMC Med Imaging. 2018 Aug 20;18(1):24. doi: 10.1186/s12880-018-0264-6.
citation: Havsteen I, Ovesen C, Willer L, Nybing JD, AEgidius K, Marstrand J, Meden P, Rosenbaum S, Folke MN, Christensen H, Christensen A. Small cortical grey matter lesions show no persistent infarction in transient ischaemic attack? A prospective cohort study. BMJ Open. 2018 Jan 21;8(1):e018160. doi: 10.1136/bmjopen-2017-018160.
citation: Havsteen I, Ovesen C, Willer L, Nybing JD, AEgidius K, Marstrand J, Meden P, Rosenbaum S, Folke MN, Christensen H, Christensen A. Comparison of 3- and 20-Gradient Direction Diffusion-Weighted Imaging in a Clinical Subacute Cohort of Patients with Transient Ischemic Attack: Application of Standard Vendor Protocols for Lesion Detection and Final Infarct Size Projection. Front Neurol. 2017 Dec 18;8:691. doi: 10.3389/fneur.2017.00691. eCollection 2017.