Bedside detection of intracranial midline shift using portable magnetic resonance imaging

Kevin N. Sheth; Matthew M. Yuen; Mercy H. Mazurek; Bradley A. Cahn; Anjali M. Prabhat; Sadegh Salehi; Jill T. Shah; Samantha By; E. Brian Welch; Michal Sofka; Laura I. Sacolick; Jennifer A. Kim; Seyedmehdi Payabvash; Guido J. Falcone; Emily J. Gilmore; David Y. Hwang; Charles Matouk; Barbara Gordon-Kundu; Adrienne Ward Rn; Nils Petersen; Joseph Schindler; Kevin T. Gobeske; Lauren H. Sansing; Gordon Sze; Matthew S. Rosen; W. Taylor Kimberly; Prantik Kundu

doi:10.1038/s41598-021-03892-7

Bedside detection of intracranial midline shift using portable magnetic resonance imaging

Kevin N. Sheth, Matthew M. Yuen, Mercy H. Mazurek, Bradley A. Cahn, Anjali M. Prabhat, Sadegh Salehi, Jill T. Shah, Samantha By, E. Brian Welch, Michal Sofka, Laura I. Sacolick, Jennifer A. Kim, Seyedmehdi Payabvash, Guido J. Falcone, Emily J. Gilmore, David Y. Hwang, Charles Matouk, Barbara Gordon-Kundu, Adrienne Ward Rn, Nils PetersenJoseph Schindler, Kevin T. Gobeske, Lauren H. Sansing, Gordon Sze, Matthew S. Rosen, W. Taylor Kimberly, Prantik Kundu

Research output: Contribution to journal › Article › peer-review

26 Scopus citations

Abstract

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.

Original language	English
Article number	67
Journal	Scientific Reports
Volume	12
Issue number	1
DOIs	https://doi.org/10.1038/s41598-021-03892-7
State	Published - Dec 2022
Externally published	Yes

Access to Document

10.1038/s41598-021-03892-7

Cite this

Sheth, K. N., Yuen, M. M., Mazurek, M. H., Cahn, B. A., Prabhat, A. M., Salehi, S., Shah, J. T., By, S., Welch, E. B., Sofka, M., Sacolick, L. I., Kim, J. A., Payabvash, S., Falcone, G. J., Gilmore, E. J., Hwang, D. Y., Matouk, C., Gordon-Kundu, B., Rn, A. W., ... Kundu, P. (2022). Bedside detection of intracranial midline shift using portable magnetic resonance imaging. Scientific Reports, 12(1), Article 67. https://doi.org/10.1038/s41598-021-03892-7

@article{e0f7fc2e6e6541d1b4499349fd4d46ee,

title = "Bedside detection of intracranial midline shift using portable magnetic resonance imaging",

abstract = "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.",

author = "Sheth, {Kevin N.} and Yuen, {Matthew M.} and Mazurek, {Mercy H.} and Cahn, {Bradley A.} and Prabhat, {Anjali M.} and Sadegh Salehi and Shah, {Jill T.} and Samantha By and Welch, {E. Brian} and Michal Sofka and Sacolick, {Laura I.} and Kim, {Jennifer A.} and Seyedmehdi Payabvash and Falcone, {Guido J.} and Gilmore, {Emily J.} and Hwang, {David Y.} and Charles Matouk and Barbara Gordon-Kundu and Rn, {Adrienne Ward} and Nils Petersen and Joseph Schindler and Gobeske, {Kevin T.} and Sansing, {Lauren H.} and Gordon Sze and Rosen, {Matthew S.} and Kimberly, {W. Taylor} and Prantik Kundu",

note = "Publisher Copyright: {\textcopyright} 2022, The Author(s).",

year = "2022",

month = dec,

doi = "10.1038/s41598-021-03892-7",

language = "English",

volume = "12",

journal = "Scientific Reports",

issn = "2045-2322",

publisher = "Nature Publishing Group",

number = "1",

}

Sheth, KN, Yuen, MM, Mazurek, MH, Cahn, BA, Prabhat, AM, Salehi, S, Shah, JT, By, S, Welch, EB, Sofka, M, Sacolick, LI, Kim, JA, Payabvash, S, Falcone, GJ, Gilmore, EJ, Hwang, DY, Matouk, C, Gordon-Kundu, B, Rn, AW, Petersen, N, Schindler, J, Gobeske, KT, Sansing, LH, Sze, G, Rosen, MS, Kimberly, WT & Kundu, P 2022, 'Bedside detection of intracranial midline shift using portable magnetic resonance imaging', Scientific Reports, vol. 12, no. 1, 67. https://doi.org/10.1038/s41598-021-03892-7

TY - JOUR

T1 - Bedside detection of intracranial midline shift using portable magnetic resonance imaging

AU - Sheth, Kevin N.

AU - Yuen, Matthew M.

AU - Mazurek, Mercy H.

AU - Cahn, Bradley A.

AU - Prabhat, Anjali M.

AU - Salehi, Sadegh

AU - Shah, Jill T.

AU - By, Samantha

AU - Welch, E. Brian

AU - Sofka, Michal

AU - Sacolick, Laura I.

AU - Kim, Jennifer A.

AU - Payabvash, Seyedmehdi

AU - Falcone, Guido J.

AU - Gilmore, Emily J.

AU - Hwang, David Y.

AU - Matouk, Charles

AU - Gordon-Kundu, Barbara

AU - Rn, Adrienne Ward

AU - Petersen, Nils

AU - Schindler, Joseph

AU - Gobeske, Kevin T.

AU - Sansing, Lauren H.

AU - Sze, Gordon

AU - Rosen, Matthew S.

AU - Kimberly, W. Taylor

AU - Kundu, Prantik

PY - 2022/12

Y1 - 2022/12

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85122428179&partnerID=8YFLogxK

U2 - 10.1038/s41598-021-03892-7

DO - 10.1038/s41598-021-03892-7

M3 - Article

C2 - 34996970

AN - SCOPUS:85122428179

SN - 2045-2322

VL - 12

JO - Scientific Reports

JF - Scientific Reports

IS - 1

M1 - 67

ER -

Bedside detection of intracranial midline shift using portable magnetic resonance imaging

Abstract

Access to Document

Fingerprint

Cite this