Abstract WP413: Portable, Bedside, Point of Care Magnetic Resonance Imaging in an Intensive Care Setting for Intracranial Hemorrhage
| Autor: | Joseph Schindler, Bradley A Cahn, Adam Jasne, Richa Sharma, Kevin N. Sheth, Matthew M Yuen, Matthew S. Rosen, Samantha By, Edward B Welch, Nils H Petersen, Mercy H Mazurek, Laura Sacolick, Kevin T Gobeske, Gordon Sze, Charles C. Matouk, Lauren H Sansing, Emily J. Gilmore, Sam Payabvash, Guido J. Falcone, Adrienne Ward, Rachel Beekman, Audrey C Leasure, Jill T Shah, W. T Kimberly, Charles R. Wira, Stacy C Brown |
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| Rok vydání: | 2020 |
| Předmět: |
Advanced and Specialized Nursing
Intracerebral hemorrhage medicine.medical_specialty medicine.diagnostic_test business.industry Magnetic resonance imaging 030204 cardiovascular system & hematology Stroke care medicine.disease 03 medical and health sciences 0302 clinical medicine Neuroimaging Patient Transport Intensive care medicine Neurology (clinical) Cardiology and Cardiovascular Medicine Intensive care medicine business Stroke 030217 neurology & neurosurgery Point of care |
| Zdroj: | Stroke. 51 |
| ISSN: | 1524-4628 0039-2499 |
| Popis: | Background: Radiographic diagnosis of intracranial hemorrhage (ICH) is a critical determinant of stroke care pathways requiring patient transport to a neuroimaging suite. Advances in low-field MRI have made it possible to obtain clinically useful imaging at the point of care (POC). Aim: The aim of this study was to obtain preliminary data regarding the ability of a bedside POC MRI scanner to detect ICH. Methods: We studied 36 patients with a diagnosis of ICH (n=18) or ischemic stroke (n=18). Five blinded readers independently evaluated T2W and FLAIR exams acquired prospectively on a 64 mT, portable bedside MRI system (Hyperfine Research, Inc). Kappa coefficients (κ) were calculated to determine inter-rater agreement. Ground truth was obtained from the clinical report of the closest conventional imaging study (17.9 ± 10.4 hours) and verified by a core reader. For each exam, majority consensus among raters was used to determine sensitivity. Results: ICH volume ranged from 4 to 101 cc (median of 13 cc). Exams were acquired within 7 days of symptom onset (51.1 ± 28.8 hours). A pathologic lesion was identified on every exam with 100% sensitivity. Sensitivity for distinguishing any hemorrhage was 89% and specificity was 83%. The mean sensitivity and specificity for individual raters was 79% and 69%, respectively. When limited to supratentorial hemorrhage, consensus sensitivity was 94%. For ICH cases detected by all raters (n=9), there was 100% accuracy for localizing the bleed (lobar vs. non-lobar) with perfect agreement among raters (κ = 1, p Conclusions: These data suggest that low-field, POC MRI may be used to detect hemorrhagic stroke at the bedside. Further work is needed to evaluate this approach in the hyperacute setting and across a wide range of ICH characteristics. |
| Databáze: | OpenAIRE |
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