Comparison of Functional MRI and CT Perfusion Imaging in Acute Stroke Management.

Background: Acute ischemic stroke is a leading cause of morbidity and mortality worldwide. Early and accurate imaging is crucial for effective management and improving patient outcomes. Functional MRI (fMRI) and CT perfusion imaging (CTP) are two advanced imaging modalities used to assess ischemic lesions. This study aims to compare the effectiveness and accuracy of fMRI and CTP in acute stroke management. Objective: To compare the effectiveness and accuracy of fMRI and CTP in acute stroke management, focusing on early detection, lesion characterization, and outcome prediction. Methods: A prospective cohort study was conducted on 100 patients presenting with acute ischemic stroke within 6 hours of symptom onset. Each patient underwent both fMRI and CTP imaging. Key metrics assessed included time to image acquisition, sensitivity, specificity, lesion detection and characterization, and predictive value for functional outcomes measured by the modified Rankin Scale (mRS) at 90 days. Results: The mean time from patient arrival to image acquisition was 30 minutes (±5) for fMRI and 25 minutes (±4) for CTP (p < 0.05). Sensitivity for detecting ischemic lesions was 95% for fMRI and 90% for CTP, while specificity was 92% for fMRI and 88% for CTP (p < 0.05). fMRI detected 120 lesions compared to 110 by CTP and characterized penumbra versus core infarct in 90% of cases compared to 85% for CTP (p < 0.05). The correlation coefficient for predicting functional outcomes was 0.85 for fMRI and 0.80 for CTP (p < 0.01). Functional independence (mRS 0-2) was achieved in 60% of fMRI patients and 55% of CTP patients (p < 0.05). Conclusion: Both fMRI and CTP are effective in acute stroke management. However, fMRI showed higher sensitivity, specificity, superior lesion detection and characterization, and better predictive value for functional outcomes. fMRI may be a more reliable tool for early stroke assessment, though CTP remains a valuable alternative when fMRI is not available. [ABSTRACT FROM AUTHOR]