Edinburgh Napier University

  Objectives: To assess organisational and patient specific limitations and safety of magnetic resonance
imaging (MRI) as the first line investigation for hospital admitted stroke patients.
Methods: Consecutive patients admitted with acute stroke were assessed and an attempt was made to
perform MRI in all patients. Oxygen saturation and interventions required during scanning were recorded.
Results: Among 136 patients recruited over 34 weeks, 85 (62%) underwent MRI. The patients’ medical
instability (15 of the 53 not scanned), contraindications to MRI (six of the 53 not scanned), and rapid
symptom resolution (10 of the 53 not scanned) were the main reasons for not performing MRI. Of the 85
patients who underwent MRI, 26 required physical intervention, 17 did not complete scanning, and 11 of
the 61 who had successful oxygen saturation monitoring were hypoxic during MRI. Organisational
limitations accounted for only 13% of failures to scan.
Conclusions: Up to 85% of hospital admitted acute stroke patients could have MRI as first line imaging
investigation, but medical instability is the major limitation. Hypoxia is frequent in MRI. Patients should be
monitored carefully, possibly by an experienced clinician, during scanning.