The comparison of MRI and CT protocol examination times for mechanical thrombectomy in acute ischemic stroke.

In acute ischemic stroke (AIS), where the shortest possible assessment is required to minimize time to mechanical thrombectomy (MT). With recent advancements in MRI reconstruction technology, MRI has also become valuable in the decision-making process for AIS treatment planning. In this study, we compared the examination times of our MRI protocol with those of a standard CT protocol for evaluating AIS through phantom simulations to obtain timing information directly relevant to treatment strategies, and evaluated the utility of MRI for MT. Ten radiological technologists performed scans using the same phantom for each modality. Evaluation items included time for hemorrhage detection, time for penumbra evaluation, and time for brain artery evaluation, and total examination time. The total examination time was slightly shorter with CT (696.2 ± 52.7 s) compared to MRI (701.8 ± 15.8 s), although this difference was not statistically significant (p = 0.4). For other parameters, MRI demonstrated significantly faster detection times: hemorrhage detection (CT, 80.9 ± 12.8 s; MRI, 66.3 ± 1.7 s; p = 0.0002), penumbra evaluation (CT, 696.2 ± 52.7 s; MRI, 262.1 ± 9.3 s; p = 0.0002), and brain artery evaluation (CT, 592.1 ± 32.3 s; MRI, 367.8 ± 8.3 s; p = 0.0002). The coefficient of variation (CV) was lower for MRI compared to CT, indicating less variability in examination times with MRI. This study demonstrates that MRI protocols, including perfusion imaging, can more rapidly visualize factors essential for MT decision-making and do not delay time to MT.