Intravenous therapy at basilar artery occlusion: MRI findings at 1.5 and 3 T

Purpose: Acute basilar artery occlusion is a life threatening condition which requires rapid diagnosis and treatment. The purpose of this paper is to compare MR findings of basilar artery occlusion before and after systemic treatment at 1.5 and 3 T. Material and Methods: MRI was performed according to a stroke protocol in a patient with acute basilar artery occlusion before and after systemic treatment. The examinations at 1.5 and 3 T included T2- and diffusion-weighted sequences as well as MRA using a time-of-flight technique. Results: The initial MRI demonstrated basilar artery occlusion as well as early signs of brainstem ischemia. Complete recanalization was achieved by systemic therapy with rt-PA and Abciximab. MRI at 3 T supplied superior flow information by MRA and demonstrated high sensitivity for intracerebral haemorrhage. Diffusion-weighted images at 3 T were of good quality and not degraded by susceptibility artefacts in the posterior fossa. Conclusions: Stroke-MRI for basilar artery occlusion can be performed at 1.5 and 3 T. The advantages of high-field MRI seem to be superior quality of MRA and high sensitivity for intracerebral haemorrhage. Basilar artery recanalization can be achieved using a systemic protocol combining rt-PA with Abciximab