The Necessity of Using MRI as an Imaging Modality in Acute Code Stroke in Indonesia
Rakhmad Hidayat,1– 3,* Marc Fisher,4,* Siti Pujiwati Permata Rima,2,* Elvan Wiyarta,1,3,* Gemia Clarisa Fathi,1,3,* Alyssa Putri Mustika,1,2,* Aruni Cahya Irfannadhira,1,3,* David Pangeran,1,2,* Taufik Mesiano,1,2,* Mohammad Kur...
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Dove Medical Press
2025-04-01
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| Series: | Vascular Health and Risk Management |
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| author | Hidayat R Fisher M Rima SPP Wiyarta E Fathi GC Mustika AP Irfannadhira AC Pangeran D Mesiano T Kurniawan M Rasyid A Harris S |
| author_facet | Hidayat R Fisher M Rima SPP Wiyarta E Fathi GC Mustika AP Irfannadhira AC Pangeran D Mesiano T Kurniawan M Rasyid A Harris S |
| author_sort | Hidayat R |
| collection | DOAJ |
| description | Rakhmad Hidayat,1– 3,* Marc Fisher,4,* Siti Pujiwati Permata Rima,2,* Elvan Wiyarta,1,3,* Gemia Clarisa Fathi,1,3,* Alyssa Putri Mustika,1,2,* Aruni Cahya Irfannadhira,1,3,* David Pangeran,1,2,* Taufik Mesiano,1,2,* Mohammad Kurniawan,1,2,* Al Rasyid,1,2,* Salim Harris1,2,* 1Department of Neurology, Faculty of Medicine University of Indonesia, Jakarta, Indonesia; 2Department of Neurology, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia; 3Universitas Indonesia Hospital, Depok, Indonesia; 4Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA*These authors contributed equally to this workCorrespondence: Rakhmad Hidayat, Email rhidayat.md@gmail.comPurpose: To evaluate the performance and outcomes of the 6-minute magnetic resonance imaging (MRI) protocol in diagnosing stroke within Indonesian healthcare setting compared to computed tomography (CT).Patients and methods: This retrospective single-center study was conducted at the Universitas Indonesia Hospital in Depok, Indonesia from September 2021 to September 2023. Patients who were diagnosed with acute stroke underwent a clinical evaluation and a 6-minute MRI protocol. The primary objective was to assess the efficiency of the 6-minute MRI protocol in promptly and accurately evaluating acute stroke patients, including determining average MRI time, thrombolysis eligibility, and post-thrombolysis outcomes compared to CT imaging. Exclusions comprised those requiring resuscitation, lack of stroke code activation, or having incomplete documentation.Results: This study involved 182 stroke patients, 136 of which underwent MRI and 46 had CT scans. Thrombolysis eligibility was similar between the groups (48.9% for MRI vs 47.8% for CT-Scan), but a higher proportion of eligible MRI patients received thrombolysis (70.1% vs 54.5%, p = 0.037). MRI also achieved shorter door-to-imaging times, especially from February to June 2022. Among those treated for ischemic stroke via MRI, 70.3% showed improvement compared to 55% for CT (p=0.016). Door-to-MRI times varied across periods, averaging 88.2 minutes before national healthcare insurance collaboration, 29.1 minutes during transition, and 47.8 minutes afterward.Conclusion: This study emphasizes the crucial role of the 6-minute MRI protocol for accurately diagnosing stroke types, severity, and determining thrombolysis eligibility. Positive outcomes in thrombolysis patients using this protocol highlight its effectiveness. However, prolonged time-to-MRI indicates the need for further improvement. Optimizing time management and workflow efficiency are critical for improving treatment efficacy and safety.Keywords: MRI, CT-scan, code stroke, developing country, thrombolysis |
| format | Article |
| id | doaj-art-bb7e1d09e18d4136a3fffbfe8f3e8f35 |
| institution | OA Journals |
| issn | 1178-2048 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Vascular Health and Risk Management |
| spelling | doaj-art-bb7e1d09e18d4136a3fffbfe8f3e8f352025-08-20T02:08:11ZengDove Medical PressVascular Health and Risk Management1178-20482025-04-01Volume 21207215101801The Necessity of Using MRI as an Imaging Modality in Acute Code Stroke in IndonesiaHidayat RFisher MRima SPPWiyarta EFathi GCMustika APIrfannadhira ACPangeran DMesiano TKurniawan MRasyid AHarris SRakhmad Hidayat,1– 3,* Marc Fisher,4,* Siti Pujiwati Permata Rima,2,* Elvan Wiyarta,1,3,* Gemia Clarisa Fathi,1,3,* Alyssa Putri Mustika,1,2,* Aruni Cahya Irfannadhira,1,3,* David Pangeran,1,2,* Taufik Mesiano,1,2,* Mohammad Kurniawan,1,2,* Al Rasyid,1,2,* Salim Harris1,2,* 1Department of Neurology, Faculty of Medicine University of Indonesia, Jakarta, Indonesia; 2Department of Neurology, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia; 3Universitas Indonesia Hospital, Depok, Indonesia; 4Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA*These authors contributed equally to this workCorrespondence: Rakhmad Hidayat, Email rhidayat.md@gmail.comPurpose: To evaluate the performance and outcomes of the 6-minute magnetic resonance imaging (MRI) protocol in diagnosing stroke within Indonesian healthcare setting compared to computed tomography (CT).Patients and methods: This retrospective single-center study was conducted at the Universitas Indonesia Hospital in Depok, Indonesia from September 2021 to September 2023. Patients who were diagnosed with acute stroke underwent a clinical evaluation and a 6-minute MRI protocol. The primary objective was to assess the efficiency of the 6-minute MRI protocol in promptly and accurately evaluating acute stroke patients, including determining average MRI time, thrombolysis eligibility, and post-thrombolysis outcomes compared to CT imaging. Exclusions comprised those requiring resuscitation, lack of stroke code activation, or having incomplete documentation.Results: This study involved 182 stroke patients, 136 of which underwent MRI and 46 had CT scans. Thrombolysis eligibility was similar between the groups (48.9% for MRI vs 47.8% for CT-Scan), but a higher proportion of eligible MRI patients received thrombolysis (70.1% vs 54.5%, p = 0.037). MRI also achieved shorter door-to-imaging times, especially from February to June 2022. Among those treated for ischemic stroke via MRI, 70.3% showed improvement compared to 55% for CT (p=0.016). Door-to-MRI times varied across periods, averaging 88.2 minutes before national healthcare insurance collaboration, 29.1 minutes during transition, and 47.8 minutes afterward.Conclusion: This study emphasizes the crucial role of the 6-minute MRI protocol for accurately diagnosing stroke types, severity, and determining thrombolysis eligibility. Positive outcomes in thrombolysis patients using this protocol highlight its effectiveness. However, prolonged time-to-MRI indicates the need for further improvement. Optimizing time management and workflow efficiency are critical for improving treatment efficacy and safety.Keywords: MRI, CT-scan, code stroke, developing country, thrombolysishttps://www.dovepress.com/the-necessity-of-using-mri-as-an-imaging-modality-in-acute-code-stroke-peer-reviewed-fulltext-article-VHRMmrict-scancode strokedeveloping countrythrombolysis |
| spellingShingle | Hidayat R Fisher M Rima SPP Wiyarta E Fathi GC Mustika AP Irfannadhira AC Pangeran D Mesiano T Kurniawan M Rasyid A Harris S The Necessity of Using MRI as an Imaging Modality in Acute Code Stroke in Indonesia Vascular Health and Risk Management mri ct-scan code stroke developing country thrombolysis |
| title | The Necessity of Using MRI as an Imaging Modality in Acute Code Stroke in Indonesia |
| title_full | The Necessity of Using MRI as an Imaging Modality in Acute Code Stroke in Indonesia |
| title_fullStr | The Necessity of Using MRI as an Imaging Modality in Acute Code Stroke in Indonesia |
| title_full_unstemmed | The Necessity of Using MRI as an Imaging Modality in Acute Code Stroke in Indonesia |
| title_short | The Necessity of Using MRI as an Imaging Modality in Acute Code Stroke in Indonesia |
| title_sort | necessity of using mri as an imaging modality in acute code stroke in indonesia |
| topic | mri ct-scan code stroke developing country thrombolysis |
| url | https://www.dovepress.com/the-necessity-of-using-mri-as-an-imaging-modality-in-acute-code-stroke-peer-reviewed-fulltext-article-VHRM |
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