FAST MRI and Neuro Emergencies

Time Is Tissue: Trad MRI’s exam time too often limits its use in emergent settings. Focused Abbreviated Survey Techniques (FAST) protocols put time back on the clock. Fomenting rapid inclusion/exclusion of life-altering conditions, FAST helps make confident decisions sans the comprehensive scan’s half-hour wait.

  • Stroke: Uses abbreviated sequences—with or without contrast—to detect acute ischemia and large-vessel occlusions.
  • Spine: Screening tool for cord compression that can be completed in sub 20 minutes, versus 90 minutes for a total spine protocol.
  • Peds: Motion-robust, non-sedated approach for monitoring shunted hydrocephalus or evaluating fluid-filled regions in ca. 4 minutes or less.
  • EPIMix: Ultra-fast, 1-minute full-brain exam that provides multiple contrasts (T1, T2, FLAIR, DWI) simultaneously.

More Than Magnets: Success needs more than speed. As Dr. Laura B. Eisenmenger detailed in our Implementing FAST MRI Protocols Online Course, truly iterative implementation takes a dedicated kind of buy in:

  • Clinicians must be on board with targeted exams, rather than comprehensive ones for specific indications.
  • Utilizing dedicated ED scanners and radiology-specific transporters has been shown to significantly reduce order-to-first-image times.
  • Staff turnover may mean yearly education to maintain efficient throughput and culture.

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RadFYI: FAST’s future is in artificially deep reconstruction. Tech à la AIR Recon DL or Deep Resolve allows for even higher acceleration factors and noise reduction, perhaps slashing times further without sacrificing the quality required for ED triage.

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