It is impossible to reliably differentiate infarct from hemorrhage by clinical examination alone. Brain imaging is required to guide management, including the selection of time-sensitive acute stroke treatments. A key decision making component of EVT is based upon imaging selection with non-contrast CT (NCCT) and Multiphase Computed Tomography Angiography (CTA). ENITS has been recommended as the viewing platform for the multiphase CTA protocol. ENITS is connected to 101 Ontario hospitals and supports the emergency consultative process facilitated by CritiCall Ontario.
In 2016, the Heart and Stroke Foundations released the Key Quality Indicators for Stroke Care. The national benchmark for imaging protocols is Door to CT/CTA: ≤ 15 minutes.