CT and MRI-based door-needle-times for acute stroke patients a quasi-randomized clinical trial

•First randomized trial comparing thrombolytic treatment-delay for CT versus MRI-examined acute stroke patients.•The trial is based on a comprehensive number of consecutive patients and was conducted in a well-established stroke-unit.•MRI was not feasible in 48.9% of MRI-allocated.•CT-based thrombolysis in acute stroke patients is significantly faster compared with MRI-based assessment.•MR-based assessment of acute stroke patients prior to intravenous treatment is a potential option in the acute stroke setting.

ObjectivesDoor-Needle-times (DNT) of 20 min are feasible when Computer Tomography (CT) is used for first-line brain-imaging to assess stroke-patients' eligibility for intravenous-tissue-Plasminogen-Activator (iv-tPA), but the more time-consuming Magnetic Resonance Imaging (MRI)-based-evaluation is superior in detecting acute ischaemia.