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In patients with suspected stroke, magnetic resonance imaging is more sensitive than computed tomography for acute ischemia. Moreover, MRI appears to be as accurate as CT for detecting intracranial hemorrhage (see http://general-medicine.jwatch.org/cgi/content/full/2004/1102/2). Yet, for emergency evaluation of suspected stroke in unselected patients, CT and MRI have not been compared for accuracy, and CT remains the most common imaging study in this setting.
Researchers identified 356 consecutive emergency-department patients with suspected stroke (median age, 76) who had no contraindications to undergoing both MRI and CT before initiation of therapy. All patients underwent both studies (MRI first in 85%); all images were analyzed by four e…