Portable, bedside, low-field magnetic resonance imaging for evaluation of intracerebral hemorrhage

Mercy H. Mazurek, Bradley A. Cahn, Matthew M. Yuen, Anjali M. Prabhat, Isha R. Chavva, Jill T. Shah, Anna L. Crawford, E. Brian Welch, Jonathan Rothberg, Laura Sacolick, Michael Poole, Charles Wira, Charles C. Matouk, Adrienne Ward, Nona Timario, Audrey Leasure, Rachel Beekman, Teng J. Peng, Jens Witsch, Joseph P. Antonios, Guido J. Falcone, Kevin T. Gobeske, Nils Petersen, Joseph Schindler, Lauren Sansing, Emily J. Gilmore, David Y. Hwang, Jennifer A. Kim, Ajay Malhotra, Gordon Sze, Matthew S. Rosen, W. Taylor Kimberly () and Kevin N. Sheth ()
Additional contact information
Mercy H. Mazurek: Yale School of Medicine
Bradley A. Cahn: Yale School of Medicine
Matthew M. Yuen: Yale School of Medicine
Anjali M. Prabhat: Yale School of Medicine
Isha R. Chavva: Yale School of Medicine
Jill T. Shah: Yale School of Medicine
Anna L. Crawford: Yale School of Medicine
E. Brian Welch: Hyperfine Research, Inc
Jonathan Rothberg: Hyperfine Research, Inc
Laura Sacolick: Hyperfine Research, Inc
Michael Poole: Hyperfine Research, Inc
Charles Wira: Yale School of Medicine
Charles C. Matouk: Yale School of Medicine
Adrienne Ward: Neuroscience Intensive Care Unit, Yale New Haven Hospital
Nona Timario: Neuroscience Intensive Care Unit, Yale New Haven Hospital
Audrey Leasure: Yale School of Medicine
Rachel Beekman: Yale School of Medicine
Teng J. Peng: Yale School of Medicine
Jens Witsch: Yale School of Medicine
Joseph P. Antonios: Yale School of Medicine
Guido J. Falcone: Yale School of Medicine
Kevin T. Gobeske: Yale School of Medicine
Nils Petersen: Yale School of Medicine
Joseph Schindler: Yale School of Medicine
Lauren Sansing: Yale School of Medicine
Emily J. Gilmore: Yale School of Medicine
David Y. Hwang: Yale School of Medicine
Jennifer A. Kim: Yale School of Medicine
Ajay Malhotra: Yale University School of Medicine
Gordon Sze: Yale University School of Medicine
Matthew S. Rosen: Massachusetts General Hospital
W. Taylor Kimberly: Massachusetts General Hospital
Kevin N. Sheth: Yale School of Medicine

Nature Communications, 2021, vol. 12, issue 1, 1-11

Abstract: Abstract Radiological examination of the brain is a critical determinant of stroke care pathways. Accessible neuroimaging is essential to detect the presence of intracerebral hemorrhage (ICH). Conventional magnetic resonance imaging (MRI) operates at high magnetic field strength (1.5–3 T), which requires an access-controlled environment, rendering MRI often inaccessible. We demonstrate the use of a low-field MRI (0.064 T) for ICH evaluation. Patients were imaged using conventional neuroimaging (non-contrast computerized tomography (CT) or 1.5/3 T MRI) and portable MRI (pMRI) at Yale New Haven Hospital from July 2018 to November 2020. Two board-certified neuroradiologists evaluated a total of 144 pMRI examinations (56 ICH, 48 acute ischemic stroke, 40 healthy controls) and one ICH imaging core lab researcher reviewed the cases of disagreement. Raters correctly detected ICH in 45 of 56 cases (80.4% sensitivity, 95%CI: [0.68–0.90]). Blood-negative cases were correctly identified in 85 of 88 cases (96.6% specificity, 95%CI: [0.90–0.99]). Manually segmented hematoma volumes and ABC/2 estimated volumes on pMRI correlate with conventional imaging volumes (ICC = 0.955, p = 1.69e-30 and ICC = 0.875, p = 1.66e-8, respectively). Hematoma volumes measured on pMRI correlate with NIH stroke scale (NIHSS) and clinical outcome (mRS) at discharge for manual and ABC/2 volumes. Low-field pMRI may be useful in bringing advanced MRI technology to resource-limited settings.

Date: 2021
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DOI: 10.1038/s41467-021-25441-6

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