Bedside detection of intracranial midline shift using portable magnetic resonance imaging.
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
07 01 2022
07 01 2022
Historique:
received:
29
03
2021
accepted:
02
12
2021
entrez:
8
1
2022
pubmed:
9
1
2022
medline:
24
2
2022
Statut:
epublish
Résumé
Neuroimaging is crucial for assessing mass effect in brain-injured patients. Transport to an imaging suite, however, is challenging for critically ill patients. We evaluated the use of a low magnetic field, portable MRI (pMRI) for assessing midline shift (MLS). In this observational study, 0.064 T pMRI exams were performed on stroke patients admitted to the neuroscience intensive care unit at Yale New Haven Hospital. Dichotomous (present or absent) and continuous MLS measurements were obtained on pMRI exams and locally available and accessible standard-of-care imaging exams (CT or MRI). We evaluated the agreement between pMRI and standard-of-care measurements. Additionally, we assessed the relationship between pMRI-based MLS and functional outcome (modified Rankin Scale). A total of 102 patients were included in the final study (48 ischemic stroke; 54 intracranial hemorrhage). There was significant concordance between pMRI and standard-of-care measurements (dichotomous, κ = 0.87; continuous, ICC = 0.94). Low-field pMRI identified MLS with a sensitivity of 0.93 and specificity of 0.96. Moreover, pMRI MLS assessments predicted poor clinical outcome at discharge (dichotomous: adjusted OR 7.98, 95% CI 2.07-40.04, p = 0.005; continuous: adjusted OR 1.59, 95% CI 1.11-2.49, p = 0.021). Low-field pMRI may serve as a valuable bedside tool for detecting mass effect.
Identifiants
pubmed: 34996970
doi: 10.1038/s41598-021-03892-7
pii: 10.1038/s41598-021-03892-7
pmc: PMC8742125
doi:
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
67Subventions
Organisme : NINDS NIH HHS
ID : K23 NS110980
Pays : United States
Organisme : NIBIB NIH HHS
ID : R01 EB031114
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States
Organisme : American Heart Association
ID : 17CSA3355004
Informations de copyright
© 2022. The Author(s).
Références
BMJ. 2008 Feb 23;336(7641):425-9
pubmed: 18270239
Lancet. 1990 Feb 10;335(8685):327-30
pubmed: 1967776
Stroke. 2003 Sep;34(9):2152-8
pubmed: 12881606
Acad Radiol. 2016 Dec;23(12):1498-1505
pubmed: 27717762
Crit Care. 2014 Dec 09;18(6):676
pubmed: 25488604
Ann Neurol. 2010 Oct;68(4):435-45
pubmed: 20865766
Stroke. 2014 Apr;45(4):1222-38
pubmed: 24481970
Stroke. 2011 Jan;42(1):73-80
pubmed: 21164136
J Neurol Neurosurg Psychiatry. 2020 May;91(5):469-474
pubmed: 32165377
J Magn Reson Imaging. 2021 Aug;54(2):372-390
pubmed: 32827173
Neurocrit Care. 2017 Feb;26(1):87-95
pubmed: 27601068
Cerebrovasc Dis. 2016;42(5-6):332-338
pubmed: 27304197
Ann Neurol. 2015 May;77(5):804-16
pubmed: 25628166
Neurocrit Care. 2013 Dec;19(3):299-305
pubmed: 23979796
Lancet Neurol. 2016 Oct;15(11):1160-9
pubmed: 27567243
Med Sci Monit. 2019 Dec 28;25:10095-10104
pubmed: 31907343
J Trauma. 2004 Mar;56(3):475-80; discussion 480-1
pubmed: 15128116
J Stroke Cerebrovasc Dis. 2013 Aug;22(6):742-9
pubmed: 22325573
Stroke. 2018 Dec;49(12):2918-2927
pubmed: 30571414
J Neuroimaging. 2018 Sep;28(5):530-534
pubmed: 29797614
J Korean Neurosurg Soc. 2010 Sep;48(3):244-50
pubmed: 21082053
Biomed Res Int. 2016;2016:5656480
pubmed: 27556036
J Neurosurg. 1990 Nov;73(5):688-98
pubmed: 2213158
J Neurotrauma. 2011 Feb;28(2):203-15
pubmed: 21294647
Acad Emerg Med. 2012 Feb;19(2):133-8
pubmed: 22320363
Stroke. 2018 Aug;49(8):1906-1912
pubmed: 29976584
Crit Care Med. 1990 Mar;18(3):278-81
pubmed: 2302952
Neurosurgery. 2006 Mar;58(3 Suppl):S16-24; discussion Si-iv
pubmed: 16710968
Nat Commun. 2021 Aug 25;12(1):5119
pubmed: 34433813
Semin Respir Crit Care Med. 2017 Dec;38(6):713-717
pubmed: 29262428
Rofo. 2017 Mar;189(3):204-217
pubmed: 28201839
Neurosurgery. 2005 Apr;56(4):681-92; discussion 681-92
pubmed: 15792506
Neurocrit Care. 2021 Sep 7;:
pubmed: 34494212
Interv Neurol. 2017 Mar;6(1-2):36-41
pubmed: 28611832
Cerebrovasc Dis. 2003;16(3):230-5
pubmed: 12865610
J Stroke. 2016 Sep;18(3):328-336
pubmed: 27733025
J Neurosurg. 1977 Oct;47(4):491-502
pubmed: 903803
JAMA Neurol. 2020 Sep 8;:
pubmed: 32897296
AJNR Am J Neuroradiol. 2009 Oct;30(9):1630-6
pubmed: 19661166
Neurology. 1997 Oct;49(4):1090-5
pubmed: 9339695
Int J Biomed Imaging. 2018 Apr 12;2018:4303161
pubmed: 29849536
J Neurol. 2008 Jun;255(6):896-902
pubmed: 18335159
Magn Reson Med. 2006 Jul;56(1):177-86
pubmed: 16724303
Lancet Neurol. 2007 Mar;6(3):215-22
pubmed: 17303527
J Am Coll Cardiol. 2004 Apr 7;43(7):1315-24
pubmed: 15063447
Curr Opin Neurol. 2010 Jun;23(3):293-9
pubmed: 20168229
N Engl J Med. 2017 Dec 28;377(26):2555-2564
pubmed: 29281579
Sci Rep. 2015 Oct 15;5:15177
pubmed: 26469756
Radiology. 2011 Mar;258(3):889-905
pubmed: 21163918
JAMA Neurol. 2018 Apr 1;75(4):453-461
pubmed: 29365017
Neurosurgery. 2006 Mar;58(3 Suppl):S25-46; discussion Si-iv
pubmed: 16540746
Neurosurgery. 2006 Mar;58(3 Suppl):S7-15; discussion Si-iv
pubmed: 16710967
Stroke. 1999 Jun;30(6):1167-73
pubmed: 10356094
Neurocrit Care. 2018 Jun;28(3):314-321
pubmed: 29139015
JAMA. 2010 Jul 14;304(2):208-9
pubmed: 20628137
Crit Care. 1999;3(5):R83-9
pubmed: 11094486
N Engl J Med. 1986 Apr 10;314(15):953-8
pubmed: 3960059
J Clin Neurosci. 2012 May;19(5):661-4
pubmed: 22377637
JAMA Neurol. 2019 Dec 1;76(12):1484-1492
pubmed: 31479116