スダ　サトシ   SUDA Satoshi   須田　智    所属   埼玉医科大学  医学部 国際医療センター　神経内科・脳卒中内科    職種   教授
論文種別	学術雑誌(原著)
言語種別	英語
査読の有無	査読あり
表題	Feasibility of using magnetic resonance imaging as a screening tool for acute stroke thrombolysis
掲載誌名	正式名：JOURNAL OF THE NEUROLOGICAL SCIENCES ISSNコード：0022-510X/1878-5883
出版社	ELSEVIER SCIENCE BV
巻・号・頁	368,168-172頁
著者・共著者	Yuki Sakamoto,Midori Tanabe,Kyoko Masuda,Hitomi Ozaki,Seiji Okubo,Satoshi Suda,Arata Abe,Junya Aoki,Kanako Muraga,Takuya Kanamaru,Kentaro Suzuki,Takehiro Katano,Kazumi Kimura
発行年月	2016/09
概要	Background: Feasibility of performing MRI first for suspected hyperacute stroke patients in real-world practice has not been fully examined. Moreover, most past studies of reducing door-to-needle time (DNT) in intravenous thrombolysis were conducted using CT. The aim of this study was to evaluate the feasibility of an MRI-first policy and examine the effects of a quality improvement (QI) process for reducing DNT using MRI. Methods: From January 2014 to August 2015, consecutive acute stroke patients who were treated with thrombolysis were prospectively enrolled into the present study. In principle, multimodal 1.5T-MRI was performed first for patients with suspected acute stroke. A step-by-step QI process for decreasing DNT, including prenotification by the emergency medical service, limiting the MRI sequence, and introduction of a rapid examination tool, was also implemented during this period. Time metrics for thrombolysis were compared between specific time periods. Results: A total of 73 patients (27 women; median age 74 years) were included in the present study. More than 80% of the patients were screened with MRI. More patients were managed with the MRI-first policy in the late phase (p = 0.018). DNT (83 min in the early phase, 68 min in the middle phase, and 54 min in the late phase, p < 0.001) was significantly reduced across phases. The percentage of patients with DNT < 60 min increased significantly across time periods (p < 0.001). Conclusion: An MRI-first policy was feasible, and DNT was substantially reduced with a QI process. This process may be applicable to other hospitals. (C) 2016 Elsevier B.V. All rights reserved.
DOI	10.1016/j.jns.2016.07.011
PMID	27538625