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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Main Authors: Hidayat R, Fisher M, Rima SPP, Wiyarta E, Fathi GC, Mustika AP, Irfannadhira AC, Pangeran D, Mesiano T, Kurniawan M, Rasyid A, Harris S
Format: Article
Language:English
Published: Dove Medical Press 2025-04-01
Series:Vascular Health and Risk Management
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Online Access: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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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
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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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