Comment je fais une IRM pour suspicion d'AVC ?

Stroke is the first cause of acquired disability in France. This generic term refers to various brain disorders of vascular origin with different clinical presentations and specific issues. The imaging strategy should be adjusted to each situation. Patients suspected of acute stroke (within 6 hours after onset of symptoms) should have a priority access to brain imaging according to HAS. MRI should be the first-line examination with short protocols (installation to interpretation time < 20 minutes) including only four sequences: DWI, FLAIR, T2* gradient-echo and TOF MRA of the Willis circle. In non-cooperative patients, motion correction (PROPELLER, MultiVane, BLADE) or ultra-short single-shot sequences can be used to preserve the image quality. In case of acute intracerebral hemorrhage, the protocol must be adjusted to the clinical situation. If necessary, contrast media can be administrated to detect an underlying cause accessible to treatment. In case of transient ischemic attack suspicion, a multimodal assessment including optimized DWI, PWI and contrast-enhanced MRA would help to determine the vascular origin of the symptoms.