Detection of Acute Brain Injury in Intensive Care Unit Patients on ECMO Support Using Ultra-Low-Field Portable MRI: A Retrospective Analysis Compared to Head CT

Author:

Cho Sung-Min123ORCID,Khanduja Shivalika1ORCID,Kim Jiah2,Kang Jin Kook1ORCID,Briscoe Jessica1ORCID,Arlinghaus Lori R.4ORCID,Dinh Kha56,Kim Bo Soo17,Sair Haris I.89,Wandji Audrey-Carelle N.10,Moreno Elena10,Torres Glenda10,Gavito-Higuera Jose11,Choi Huimahn A.10,Pitts John4,Gusdon Aaron M.10,Whitman Glenn J.1

Affiliation:

1. Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA

2. Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA

3. Division of Neuroscience Critical Care, Departments of Neurosurgery, Anesthesiology, Critical Care Medicine, The Johns Hopkins Hospital, Baltimore, MD 21287, USA

4. Hyperfine, Inc., Guilford, CT 06437, USA

5. Divisions of Pulmonary, Critical Care and Sleep Medicine, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA

6. Department of Advanced Cardiopulmonary Therapies and Transplantation, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA

7. Division of Pulmonary and Critical Care Medicine, Johns Hopkins Medicine, Baltimore, MD 21205, USA

8. Division of Neuroradiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA

9. The Malone Center for Engineering in Healthcare, The Whiting School of Engineering, Johns Hopkins University, Baltimore, MD 21218, USA

10. Division of Neurocritical Care, Department of Neurosurgery, McGovern School of Medicine, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA

11. Department of Diagnostic and Interventional Imaging, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA

Abstract

Early detection of acute brain injury (ABI) is critical to intensive care unit (ICU) patient management and intervention to decrease major complications. Head CT (HCT) is the standard of care for the assessment of ABI in ICU patients; however, it has limited sensitivity compared to MRI. We retrospectively compared the ability of ultra-low-field portable MR (ULF-pMR) and head HCT, acquired within 24 h of each other, to detect ABI in ICU patients supported on extracorporeal membrane oxygenation (ECMO). A total of 17 adult patients (median age 55 years; 47% male) were included in the analysis. Of the 17 patients assessed, ABI was not observed on either ULF-pMR or HCT in eight patients (47%). ABI was observed in the remaining nine patients with a total of 10 events (8 ischemic, 2 hemorrhagic). Of the eight ischemic events, ULF-pMR observed all eight, while HCT only observed four events. Regarding hemorrhagic stroke, ULF-pMR observed only one of them, while HCT observed both. ULF-pMR outperformed HCT for the detection of ABI, especially ischemic injury, and may offer diagnostic advantages for ICU patients. The lack of sensitivity to hemorrhage may improve with modification of the imaging acquisition program.

Funder

Hyperfine, Inc.

NIH

NINDS

Publisher

MDPI AG

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