MRI Plus Echocardiography Used to Determine Cause of Stroke

Researchers are urging more comprehensive imaging for patients with stroke symptoms after a recent study showed magnetic resonance imaging (MRI) and echocardiography together improve detection of cause and selection of treatment for cardioembolic strokes, the "meanest" type of stroke, according to the Society of Interventional Radiology (SIR).

A cardioembolic stroke is a "double whammy of both types of stroke" -- ischemic and hemorrhagic, the SIR said. In the 93-patient study, MRI detected nearly twice as many sources of stroke than echocardiogram alone. MRI also revealed more heart disease conditions contributing to clot formation. Echocardiography, however, was superior at detecting potential embolic lesions on prosthetic cardiac valves, as well as strokes related to a hole in the heart.

In the study, MRI found nine thrombi in 9.7 percent of patients and echocardiography found three vegetations on valves in 3 percent of patients. MRI did not detect any vegetations.

"A potential cardiac source should be considered in all patients presenting with ischemic strokes," John Sheehan, lead author and interventional radiologist at Northwestern University, said. "All stroke patients should routinely have an MRI and ultrasound of their heart."

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