Abstract 57: Deployment of Portable, Bedside, Low-Field Magnetic Resonance Imaging for Evaluation of Stroke Patients

Autor: Jill T Shah, Charles R. Wira, Adrienne Ward, Adam Jasne, Matthew M Yuen, Mercy H Mazurek, Bradley A Cahn, Rachel Beekman, Charles C. Matouk, Rafael O'Halloran, Richa Sharma, Joseph Schindler, Stacy C Brown, Kevin T Gobeske, Nils H Petersen, Gordon Sze, Michael Poole, W. T Kimberly, Sam Payabvash, Kevin N. Sheth, Lauren H Sansing, Hadrien A. Dyvorne, Emily J. Gilmore, Guido J. Falcone, Matthew S. Rosen
Rok vydání: 2020
Předmět:
Zdroj: Stroke. 51
ISSN: 1524-4628
0039-2499
Popis: Background: Magnetic resonance imaging (MRI) is a powerful modality for diagnosing stroke. Conventionally, patients must travel to the location of a high-field MRI device. Advances in low-field MRI have enabled acquisition of clinically useful images using a portable device at the bedside. The feasibility of using point of care (POC) MRI in a clinical stroke setting is unknown. Objective: To determine the safety and feasibility of portable, bedside, low-field MRI in a clinical setting. Design/Methods: POC MRI exams were performed in Yale’s Neuroscience Intensive Care Unit (NICU) from July 2018 to August 2019. Images were acquired at the bedside using a standard 110V, 15A power outlet. The environment included the bedside vitals monitor, ventilators and intravenous infusion pumps. Exams were performed by research staff trained to operate the POC scanner in the absence of a trained MRI technician. No special precautions were necessary to remove ferrous metals from the room. Scan parameters were controlled using a tablet computer interface, and images were available immediately after acquisition. Results: POC MRI was obtained in 85 stroke cases (46% female, ages 18-96 years, 46% ischemic stroke, 34% intracerebral hemorrhage, 20% subarachnoid hemorrhage). Scans were obtained within 7 days of symptom onset. NIHSS scores ranged from 1 to 29 (median of 7). Of the 85 patients analyzed, 68 underwent T2-weighted imaging, 72 underwent FLAIR imaging, and 39 underwent diffusion weighted imaging (DWI). DWI was only tested in ischemic stroke cases. Patients’ BMI ranged from 20.0 to 46.5 with a median of 26.7. The majority 74 (87%) of patients completed the entire exam. Five patients (6%) were unable to fit in the scanner’s 30 cm opening, while 6 patients (7%) experienced claustrophobia resulting in early termination of the exam. Mean exam time was 28.9 ± 8.4 minutes. The 64 mT static magnetic field, gradient and RF pulses of the POC MRI scanner did not interfere with NICU equipment, and no significant adverse events occurred. Conclusions: We report the first use of a portable, low-field MRI system to image stroke patients at the bedside. This early work suggests our approach is safe and viable in a complex clinical care environment.
Databáze: OpenAIRE
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