Portable MRI Useful For Bedside Assessment Of Brain Injury

A portable, low-field MRI can be useful for assessing brain injury at the bedside of critically ill patients, particularly during the COVID-19 pandemic, when patient transport is minimized to reduce transmission risk, researchers report.

“We have been working to deploy this solution for a few years,” Dr. Kevin N. Sheth of Yale University School of Medicine, in New Haven, Connecticut, told Reuters Health by email. “We continue to be amazed by the possibility of taking an MRI machine to the bedside of patients in a complex clinical environment and to do be able to do so with relative ease.”

MRI scanners operating at low field strength allow for open geometry designs and are compatible with nearby ferromagnetic materials, thereby enabling scanning outside of an MRI suite.

Dr. Sheth and colleagues evaluated the potential role of low-field, portable MRI for the assessment of brain injury at the bedside of critically ill patients in intensive-care units.

The study included 50 patients, including nine with ischemic stroke, 12 with hemorrhagic stroke, two with subarachnoid hemorrhage, three with traumatic brain injury, four with brain tumor, and 20 with COVID-19 infection with altered mental status.

The portable MRI detected neuroimaging findings in 29 of 30 patients without COVID-19, and all but one of the findings were in agreement with available conventional radiology reports. The sole exception was a patient with diffuse subarachnoid hemorrhage that was not observed on bedside MRI.

Eight of 20 COVID-19 patients had neuroimaging findings on portable MRI, including an intracranial hemorrhage in one patient, cerebral infarction in three patients, diffuse cerebral edema in one patient, and leukoencephalopathy in three patients, the researchers report in JAMA Neurology.

All portable MRI findings were in agreement with conventional radiology reports in the 11 COVID-19 patients who also received conventional neuroimaging.

“We believe this is the beginning of entirely new field of neurological evaluation and imaging,” Dr. Sheth said. “It is possible that the solution will aid in the use of MR imaging in clinical contexts and locations where MRI is previously not readily available.”

He added, “It is often natural to want to ask about comparing the images to a conventional MRI. That’s the wrong question. While the images are getting better and better, and they will continue to do so, as they have for any imaging tool, the real advancement is the portability.”

Coauthor Dr. W. Taylor Kimberly of Massachusetts General Hospital, in Boston, told Reuters Health by email, “A portable MRI, even with lower resolution than traditional MRI, opens up new possibilities for imaging in scenarios that were previously not possible. This includes both in-hospital and pre-hospital settings.”

The study was supported by the American Heart Association. Dr. Sheth is the founder and chairman of Hyperfine Research Inc, which built the technology and supports his work.

—Will Boggs MD