MRI Head Perfusion With IV Contrast Contrast-enhanced MRI head perfusion imaging (or, if available, noncontrast ASL perfusion) may detect additional abnormalities not identified on initial vascular imaging or diffusion-weighted imaging (DWI) in some patients presenting with TIA. Either technique may be useful in the secondary workup and triage of patients presenting with TIA depending on the suspected underlying etiology, particularly if no abnormalities are identified on direct vascular or parenchymal imaging studies [28-30]. Specific instances arise in patients with complete extracranial internal carotid artery occlusion in whom MR perfusion can be used to determine its hemodynamic effect [31-33]. However, selection of patients with carotid occlusion for revascularization based on hemodynamic compromise does not improve outcome [18]. MRI Head Without and With IV Contrast Noncontrast MRI head is typically sufficient for the routine assessment of uncomplicated TIA. Conditions rarely mimicking TIA include tumors and cerebral convexity subarachnoid hemorrhage due to amyloid angiopathy. MRI Cerebrovascular Diseases-Stroke without and with IV contrast may be helpful in the secondary workup of patients presenting with transient focal neurological symptoms [34]. MRI Head Without IV Contrast Owing to the relatively rapid noninvasive nature of MRI and the high sensitivity of DWI for ischemic change, MRI is the most sensitive test for acute infarct. MRI of the head may be useful in the initial or secondary evaluation of TIA to evaluate for ischemic changes on DWI or for other alternative etiologies [34,35]. MRI is particularly useful prognostically as an initial test in the setting of complete resolution of associated symptoms before presentation or shortly after presentation [29]. Additionally, MRI may be useful as an initial test on repeat clinical presentation [36].
Cerebrovascular Diseases Stroke and Stroke Related Conditions PCAs. MRI Head Perfusion With IV Contrast Contrast-enhanced MRI head perfusion imaging (or, if available, noncontrast ASL perfusion) may detect additional abnormalities not identified on initial vascular imaging or diffusion-weighted imaging (DWI) in some patients presenting with TIA. Either technique may be useful in the secondary workup and triage of patients presenting with TIA depending on the suspected underlying etiology, particularly if no abnormalities are identified on direct vascular or parenchymal imaging studies [28-30]. Specific instances arise in patients with complete extracranial internal carotid artery occlusion in whom MR perfusion can be used to determine its hemodynamic effect [31-33]. However, selection of patients with carotid occlusion for revascularization based on hemodynamic compromise does not improve outcome [18]. MRI Head Without and With IV Contrast Noncontrast MRI head is typically sufficient for the routine assessment of uncomplicated TIA. Conditions rarely mimicking TIA include tumors and cerebral convexity subarachnoid hemorrhage due to amyloid angiopathy. MRI Cerebrovascular Diseases-Stroke without and with IV contrast may be helpful in the secondary workup of patients presenting with transient focal neurological symptoms [34]. MRI Head Without IV Contrast Owing to the relatively rapid noninvasive nature of MRI and the high sensitivity of DWI for ischemic change, MRI is the most sensitive test for acute infarct. MRI of the head may be useful in the initial or secondary evaluation of TIA to evaluate for ischemic changes on DWI or for other alternative etiologies [34,35]. MRI is particularly useful prognostically as an initial test in the setting of complete resolution of associated symptoms before presentation or shortly after presentation [29]. Additionally, MRI may be useful as an initial test on repeat clinical presentation [36].