MRI May Be Preferred to CT With CT Angiography Alone for Dizziness in ED

Jul 14, 2023

THURSDAY, July 13, 2023 (HealthDay News) — For patients presenting to the emergency department with dizziness, magnetic resonance imaging (MRI) may be preferred to computed tomography (CT) with CT angiography (CTA) alone in terms of stroke management, according to a study published online July 5 in the American Journal of Roentgenology.

Long H. Tu, M.D., from the Yale School of Medicine in New Haven, Connecticut, and colleagues conducted a retrospective study including 1,917 patients presenting to the emergency department with dizziness. A first analysis included matched groups of patients discharged from the emergency department after undergoing head CT with head and neck CTA alone or brain MRI (407 patients in each group). A second analysis compared patients discharged after CT with CTA alone and those who underwent specialized abbreviated MRI for increased sensitivity for posterior circulation stroke (100 patients in each group).

The researchers found that in the first analysis, those who underwent MRI showed greater frequency of critical neuroimaging results (10.1 versus 4.7 percent), change in secondary stroke prevention medication (9.6 versus 3.2 percent), and subsequent echocardiography evaluation (6.4 versus 1.0 percent) compared with those who underwent CT with CTA alone. In the second analysis, greater frequency of critical neuroimaging results (10.0 versus 2.0 percent), change in secondary stroke prevention medication (14.0 versus 1.0 percent), and subsequent echocardiography evaluation (12.0 versus 2.0 percent) were seen for those undergoing specialized abbreviated MRI versus CT with CTA alone. The investigators also observed a lower frequency of 90-day emergency department readmissions (12.0 versus 28.0 percent).

“The findings indicate a potential role of MRI in motivating clinically impactful management changes in patients presenting with dizziness,” the authors write.

Several authors disclosed financial ties to industry.

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