Fast Door-to-Needle Times for an MRI-Based Acute Stroke Protocol

The initial acute stroke evaluation typically includes a noncontrast computed tomography (CT) to assess for intracerebral hemorrhage and early ischemic changes. Although magnetic resonance imaging (MRI) provides more information on the distribution and extent of acute ischemia, the concerns about the cost and complexity of the infrastructure required to provide immediate access to MRI and the potential for introducing treatment delays have limited the widespread adoption of acute MRI to screen patients for intravenous tissue plasminogen activator (IV tPA).

Now, researchers report the results of a quality improvement (QI) effort to reduce door-to-needle (DTN) times for two centers with existing MRI-based IV tPA protocols. A formal QI process …