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Can aortic MRI be used instead of transoesophagal echocardiography in patients with ischaemic stroke?

Correspondence to:
Dr Emmanuel Touzé, Faculté de Médecine Paris-Descartes (Paris 5), Department of Neurology, EA 4055, Centre Hospitalier Sainte-Anne, 1 rue Cabanis, 75674 Paris Cedex 14, France; e.touze@ch-sainte-anne.fr

The first 150 words of the full text of this article appear below.

High resolution MRI of the vessel wall and atherosclerotic plaque is an area of increasing development.¹ In this issue of J Neurol Neurosurg Psychiatry, Harloff and colleagues² assessed the accuracy of 3 T MRI to detect aortic sources of cerebral embolism in comparison with transoesophagal echocardiography (TOE) (see page 540). They suggest that not only is MRI reliable in detecting aortic high risk plaques, but it is also potentially more accurate in investigating aortic segments that are not identified by TOE. Although there is little doubt that vessel MRI is a very promising technique, the authors’ enthusiasm needs to be qualified.

Firstly, as underlined by the Bland and Altman plot, there is very poor agreement between the two techniques, with MRI overestimating plaque thickness and consequently classifying more patients as high risk (4 mm aortic plaques). Moreover, it is still uncertain whether the cut-off used to . . . [Full text of this article]

Relevant Article

Reliability of aortic MRI at 3 Tesla in patients with acute cryptogenic stroke

A Harloff, P Dudler, A Frydrychowicz, C Strecker, A L Stroh, A Geibel, C Weiller, A Hetzel, J Hennig, and M Markl
J. Neurol. Neurosurg. Psychiatry 2008 79: 540-546. [Abstract] [Full Text] [PDF]