Portable Magnetic Resonance Imaging Device Accurately Detects Intracranial Hemorrhage

Researchers have demonstrated that a low-field portable magnetic resonance imaging (MRI) scanner can detect intracranial hemorrhages (ICH), according to a Yale based study published in Nature Communications.

“Timely and accessible neuroimaging is a critical step in the diagnostic workup of patients presenting with suspected acute brain injury such as stroke. Since intracerebral hemorrhage is a contraindication for thrombolytic therapy, ruling out the presence of blood is one of the main decision steps in acute stroke care,” wrote Mercy H. Mazurek, Department of Neurology, Yale School of Medicine, New Haven, CT, and co-authors.

The American Heart Association recommends that patients receive rapid brain imaging before thrombolytic treatment, with the most common method being non-contrast computed tomography (CT). However, researchers noted, recent evidence suggests that multimodal MRI is just as accurate for detecting acute brain hemorrhage.

Conventional MRI scanning requires an access-controlled environment, trained technicians, and increased safety precautions, which can make MRI inaccessible as a radiological examination of the brain prior to thrombolytic treatment for unstable patients. Thus, researchers aimed to demonstrate portable MRI could be used at patient bedsides to initially detect acute brain hemorrhage, a substitute that would avoid the radiation exposure of CT.

Researchers utilized a Portable Point-of-Care MRI system, which operates at a lower cost than conventional MRI systems, is easily moved throughout the hospital, and can be used with minimal training.  The main endpoint was the presence of ICH diagnosed on portable MRI.

Between July 2018 and November 2020, neuroradiologists evaluated a total of 144 examinations (56 ICH, 48 acute ischemic stroke, 40 healthy controls). Of this, 104 exams on 94 patients with a diagnosis of acute ischemic stroke or intracerebral hemorrhage were ultimately included in this analysis.

A total of 80% of intracerebral hemorrhages were correctly identified using the portable MRI device, while 96.6% of blood-negative cases were detected. No patients or staff experienced adverse events during the portable MRI scans.

“Our observation that ICH volume measured on pMRI (portable MRI) is associated with both stroke severity and patient outcome further validates this approach as ICH volume is a well-established predictor of outcome,” concluded Mazurek et al. “These results suggest that pMRI-based neuroimaging assessments are a point-of-care solution that could be useful in a broad range of clinical settings for diagnosis and evaluation.”

Further research is needed in larger prospective, multicenter studies.

Mazurek MH, Cahn BA, Yuen MM, et al. Portable, bedside, low-field magnetic resonance imaging for evaluation of intracerebral hemorrhage. Nat Commun. 2021;12(1):5119. Published 2021 Aug 25. doi:10.1038/s41467-021-25441-6