@article {McDonald, author = {J.S. McDonald and J. Fan and D.F. Kallmes and H.J. Cloft}, title = {Pretreatment Advanced Imaging in Patients with Stroke Treated with IV Thrombolysis: Evaluation of a Multihospital Data Base}, year = {2013}, doi = {10.3174/ajnr.A3797}, publisher = {American Journal of Neuroradiology}, abstract = {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\%{\textendash}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{\textendash}1.43]; P = .0412) and MR group (OR = 1.14 [95\% CI, 1.01{\textendash}1.28]; P = .0177) and mortality was lower in the MR group (OR = 0.64 [95\% CI, 0.52{\textendash}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.}, issn = {0195-6108}, URL = {https://www.ajnr.org/content/early/2013/12/05/ajnr.A3797}, eprint = {https://www.ajnr.org/content/early/2013/12/05/ajnr.A3797.full.pdf}, journal = {American Journal of Neuroradiology} }