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
Sung-Min Cho,
Shivalika Khanduja,
Jiah Kim,
Jin Kook Kang,
Jessica Briscoe,
Lori R. Arlinghaus,
Kha Dinh,
Bo Soo Kim,
Haris I. Sair,
Audrey-Carelle N. Wandji,
Elena Moreno,
Glenda Torres,
Jose Gavito-Higuera,
Huimahn A. Choi,
John Pitts,
Aaron M. Gusdon,
Glenn J. Whitman
Affiliations
Sung-Min Cho
Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
Shivalika Khanduja
Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
Jiah Kim
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
Jin Kook Kang
Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
Jessica Briscoe
Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
Lori R. Arlinghaus
Hyperfine, Inc., Guilford, CT 06437, USA
Kha Dinh
Divisions of Pulmonary, Critical Care and Sleep Medicine, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
Bo Soo Kim
Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
Haris I. Sair
Division of Neuroradiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
Audrey-Carelle N. Wandji
Division of Neurocritical Care, Department of Neurosurgery, McGovern School of Medicine, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
Elena Moreno
Division of Neurocritical Care, Department of Neurosurgery, McGovern School of Medicine, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
Glenda Torres
Division of Neurocritical Care, Department of Neurosurgery, McGovern School of Medicine, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
Jose Gavito-Higuera
Department of Diagnostic and Interventional Imaging, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
Huimahn A. Choi
Division of Neurocritical Care, Department of Neurosurgery, McGovern School of Medicine, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
John Pitts
Hyperfine, Inc., Guilford, CT 06437, USA
Aaron M. Gusdon
Division of Neurocritical Care, Department of Neurosurgery, McGovern School of Medicine, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
Glenn J. Whitman
Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
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.
