News | Neuro Imaging | June 01, 2016

New Study Investigates Neuroimaging Use for Stroke Victims

Investigators find age, sex and race impact what type of imaging is used

stroke, neuroimaging study, Achala Vagal, ASNR, race, age, sex

June 1, 2016 — A person is admitted to the hospital with a stroke, but not much is known about whether or not that patient will undergo neuroimaging.

A team led by Achala Vagal, M.D., associate professor at the University of Cincinnati (UC) College of Medicine and a UC Health radiologist, wanted to see whether differences in race, sex and/or age mattered when it came to neuroimaging use. These findings, which showed a difference for young patients, men and African-Americans, were presented at the American Society of Neuroradiology’s (ASNR) annual meeting, May 23-26 in Washington, D.C.

“Rates of diagnostic workup in stroke have increased over time; however, less is known about differences in utilization of neuroimaging for stroke from a population perspective,” she said. “In this study, we found that age, sex and race do matter as far as neuroimaging use is concerned.”

This study used data from the National Institutes of Health (NIH)-funded Greater Cincinnati/Northern Kentucky Stroke Study for which UC Department of Neurology’s Brett Kissela, M.D., and Dawn Kleindorfer, M.D., are co-principal investigators. The dataset includes cases from hospitals, clinics, coroners’ offices, nursing homes and physician offices from a five-county region that is representative of the United States for age, percentage of African-American residents, median income and educational level. Patient charts and imaging records from stroke patients in calendar years 2005 and 2010 were pulled by research nurses and reviewed by study physicians. The proportion of imaging use within two days of stroke occurrence or hospital admission date — including head computed tomography (CT) without contrast, head magnetic resonance imaging (MRI), CT angiogram, MR angiogram and carotid ultrasound — was calculated.

Researchers also calculated odds of using advanced imaging, adjusting for insurance, the baseline using the NIH stroke scale, patients who came to the emergency room first and the hospital type — academic versus community hospital.

“In 2005, there were 3,471 stroke or mini-stroke (transient ischemic attack) events with imaging data available in 3,226 patients, and in 2010, there were 3,431 events with imaging data in 3,213 patients,” Vagal says. “We found that a higher proportion of males received MRI, 55 percent versus 51 percent, and MR angiogram, 36 percent versus 31 percent, as compared to females in both 2005 and 2010, with no gender differences in use of the other imaging techniques.

“A higher proportion of African-Americans received head CT imaging without contrast, 96 percent versus 92 percent, MRI, 59 percent versus 51 percent, and MR angiogram, 41 percent versus 31 percent, as compared to Caucasians with no racial difference in the other imaging modalities. All imaging use except CT without contrast and carotid ultrasound was higher in younger patients, aged less than 55 years, as compared to older patients.”

The odds of receiving advanced imaging was higher in younger patients (less than 55-years-old), African-American patients and patients who came to an academic center or were seen by a stroke team/neurologist. She says results also showed that odds of receiving a head CT scan without contrast did not differ significantly by age, sex and race.

“The differences discovered in this study may be partly driven by age, with younger patients getting more extensive workups and partly by access to stroke expertise,” she says. “However, further understanding of the contributors can provide an important basis for newer lines of inquiry into environmental, socioeconomic and access to healthcare issues.”

For more information: www.asnr.org

Related Content

Machine Learning IDs Markers to Help Predict Alzheimer's

Neurologists use structural and diffusion magnetic resonance imaging (MRI) to identify changes in brain tissue (both gray and white matter) that are characteristic of Alzheimer's disease and other forms of dementia. The MRI images are analyzed using morphometry and tractography techniques, which detect changes in the shape and dimensions of the brain and in the tissue microstructure, respectively. In this example, the images show the normal brain of an elderly patient. Image courtesy of Jiook Cha.

News | Neuro Imaging | September 20, 2018
New research has shown a combination of two different modes of magnetic resonance imaging (MRI), computer-based...
LVivo EF Cardiac Tool Now Available for GE Vscan Extend Handheld Mobile Ultrasound
Technology | Cardiovascular Ultrasound | September 19, 2018
DiA Imaging Analysis Ltd. (DiA), a provider of artificial intelligence (AI)-powered ultrasound analysis tools,...
PET Imaging Agent Predicts Brain Tau Pathology, Alzheimer's Diagnosis
News | PET Imaging | September 05, 2018
Eli Lilly and Co. and Avid Radiopharmaceuticals Inc. announced a Phase 3 study of positron emission tomography (PET)...
Brain Iron Levels May Predict Multiple Sclerosis Disabilities
News | Neuro Imaging | August 31, 2018
A new, highly accurate magnetic resonance imaging (MRI) technique can monitor iron levels in the brains of multiple...
Study Finds Multiple Sclerosis Drug Slows Brain Shrinkage

An NIH-funded clinical trial suggested that the anti-inflammatory drug ibudilast may slow brain shrinkage caused by progressive MS. Image courtesy of Robert J. Fox, M.D., Cleveland Clinic.

News | Neuro Imaging | August 30, 2018
August 30, 2018 — Results from a clinical...
iSchemaView RAPID Technology Now Installed in More Than 500 Stroke Centers
News | Neuro Imaging | August 27, 2018
iSchemaView announced that more than 575 stroke centers in 22 countries have selected the RAPID advanced imaging...
Brain Study of 62,454 Scans Identifies Drives of Brain Aging
News | SPECT Imaging | August 27, 2018
In the largest known brain imaging study, scientists from five institutions evaluated 62,454 brain single photon...
Abnormal Protein Concentrations Found in Brains of Military Personnel With Suspected CTE

Researchers are using the tracer, which is injected into a patient, then seen with a PET scan, to see if it is possible to diagnose chronic traumatic encephalopathy in living patients. In this image, warmer colors indicate a higher concentration of the tracer, which binds to abnormal proteins in the brain. Credit UCLA Health.

News | PET Imaging | August 24, 2018
August 24, 2018 — In a small study of
Radiation Therapy Affects Event Recall for Children With Brain Tumors
News | Radiation Therapy | August 24, 2018
Children with certain types of brain tumors who undergo radiation treatment are less likely to recall the specifics of...
MRI Study Differentiates Brains of Doers from Procrastinators
News | Neuro Imaging | August 23, 2018
Researchers at Ruhr-Universität Bochum have analysed why certain people tend to put tasks off rather than tackling them...