TY - JOUR T1 - Pretreatment Advanced Imaging in Patients with Stroke Treated with IV Thrombolysis: Evaluation of a Multihospital Data Base JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. SP - 478 LP - 481 DO - 10.3174/ajnr.A3797 VL - 35 IS - 3 AU - J.S. McDonald AU - J. Fan AU - D.F. Kallmes AU - H.J. Cloft Y1 - 2014/03/01 UR - http://www.ajnr.org/content/35/3/478.abstract N2 - BACKGROUND AND PURPOSE: CT angiography, CT perfusion, and MR imaging have all been advocated as potentially useful in treatment planning for patients with acute ischemic stroke. We evaluated a large multihospital data base to determine how the use of advanced imaging is evolving in patients treated with intravenous thrombolysis. MATERIALS AND METHODS: Patients with acute ischemic stroke receiving IV thrombolytic therapy from 2008 to 2011 were identified by using the Premier Perspective data base. Mortality and discharge to long-term care rates were compared following multivariate logistic regression between patients who received head CT only versus those who received CTA without CT perfusion, CT perfusion, or MR imaging. RESULTS: Of 12,429 included patients, 7305 (59%) were in the CT group, 2359 (19%) were in the CTA group, 848 (7%) were in the CTP group, and 1917 (15%) were in the MR group. From 2008 to 2011, the percentage of patients receiving head CT only decreased from 64% to 55%, while the percentage who received cerebral CT perfusion increased from 3% to 8%. The use of CT angiography and MR imaging marginally increased (1%–2%). Outcomes were similar between CT only and advanced imaging patients, except discharge to long-term care was slightly more frequent in the CTP group (OR = 1.17 [95% CI, 0.96–1.43]; P = .0412) and MR group (OR = 1.14 [95% CI, 1.01–1.28]; P = .0177) and mortality was lower in the MR group (OR = 0.64 [95% CI, 0.52–0.79]; P < .0001). CONCLUSIONS: Use of advanced imaging is increasing in patients treated with IV thrombolysis. While there were differences in outcomes among imaging groups, the clinical effect of advanced imaging remains unclear. ER -