Observational studyAnnals of neurology2022
Magnetic Resonance Imaging or Computed Tomography for Suspected Acute Stroke: Association of Admission Image Modality with Acute Recanalization Therapies, Workflow Metrics, and Outcomes.
Observational study in Annals of neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 4 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Safety Outcomes Following Intravenous Thrombolysis in Acute Ischemic Stroke: A Systematic Review and Network Meta-analysis.CNS drugs · 2026Pooled it
- MR Imaging versus Noncontrast CT for Selecting Patients with Acute Ischemic Stroke of Large Vessel Occlusion for Endovascular Thrombectomy: A Systematic Review and Meta-Analysis.AJNR. American journal of neuroradiology · 2025Pooled it
- Impact of stroke imaging selection modality on endovascular thrombectomy outcomes in the early and extended time windows: A meta-analysis.Brain and behavior · 2024Pooled it
- Reporting of Observational Studies Explicitly Aiming to Emulate Randomized Trials: A Systematic Review.JAMA network open · 2023Pooled it
- Susceptibility Vessel Sign and Intravenous Alteplase in Stroke Patients Treated with Thrombectomy : A Secondary Analysis of the SWIFT DIRECT Trial.Clinical neuroradiology · 2025Trial
- MRI vs CT for Baseline Imaging Evaluation in Acute Large Artery Ischemic Stroke: A Subanalysis of the SWIFT-DIRECT TrialNeurology · 2024Trial
- Multi-plane vision transformer for hemorrhage classification using axial and sagittal MRI data.Scientific reports · 2026Article
- Design and Implementation of Observational Studies Emulating a Target Trial.JAMA network open · 2026Article
- Reducing Door-to-Puncture Time with a Streamlined MRI-First Workflow for Endovascular Thrombectomy.Journal of neuroendovascular therapy · 2026Article
- Risk of intracranial haemorrhage in patients with acute ischaemic stroke and prior antiplatelet therapy.European stroke journal · 2026Article
- Current state and advancements of imaging in acute ischemic stroke: a practical review.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Review
- Moving From CT-First to MRI-First Paradigm in Acute Ischemic Stroke: Treatment Rates, Time Metrics, Safety, and Outcomes.Journal of stroke · 2025Article
- Article
- Article
- Specialist Perspectives on the Imaging Selection of Large Vessel Occlusion in the Late Window.Clinical neuroradiology · 2023Article
- Late Window Imaging Selection for Endovascular Therapy of Large Vessel Occlusion Stroke: An International Survey.Stroke (Hoboken, N.J.) · 2023Article
- Neuroimaging of Acute Ischemic Stroke: Multimodal Imaging Approach for Acute Endovascular Therapy.Journal of stroke · 2023Review
- Mechanical Thrombectomy in the Late Presentation of Anterior Circulation Large Vessel Occlusion Stroke: A Guideline From the Society of Vascular and Interventional Neurology Guidelines and Practice Standards Committee.Stroke (Hoboken, N.J.) · 2023Article
- Automated detection of hyperdense artery sign on non-contrast CT for rapid identification of large vessel occlusion: a multicenter validation study.Frontiers in neurologyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
39 authors at 20 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine rates of intravenous thrombolysis (IVT), mechanical thrombectomy (MT), door-to-needle (DTN) time, door-to-puncture (DTP) time, and functional outcome between patients with admission magnetic resonance imaging (MRI) versus computed tomography (CT).
methodsAn observational cohort study of consecutive patients using a target trial design within the nationwide Swiss-Stroke-Registry from January 2014 to August 2020 was carried out. Exclusion criteria included MRI contraindications, transferred patients, and unstable or frail patients. Multilevel mixed-effects logistic regression with multiple imputation was used to calculate adjusted odds ratios with 95% confidence intervals for IVT, MT, DTN, DTP, and good functional outcome (mRS 0-2) at 90 days.
resultsOf the 11,049 patients included (mean [SD] age, 71 [15] years; 4,811 [44%] women; 69% ischemic stroke, 16% transient ischemic attack, 8% stroke mimics, 6% intracranial hemorrhage), 3,741 (34%) received MRI and 7,308 (66%) CT. Patients undergoing MRI had lower National Institutes of Health Stroke Scale (median [interquartile range] 2 [0-6] vs 4 [1-11]), and presented later after symptom onset (150 vs 123 min, p < 0.001). Admission MRI was associated with: lower adjusted odds of IVT (aOR 0.83, 0.73-0.96), but not with MT (aOR 1.11, 0.93-1.34); longer adjusted DTN (+22 min [13-30]), but not with longer DTP times; and higher adjusted odds of favorable outcome (aOR 1.54, 1.30-1.81).
interpretationWe found an association of MRI with lower rates of IVT and a significant delay in DTN, but not in DTP and rates of MT. Given the delays in workflow metrics, prospective trials are required to show that tissue-based benefits of baseline MRI compensate for the temporal benefits of CT. ANN NEUROL 2022;92:184-194.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.