Bedside detection of intracranial midline shift using portable magnetic resonance imaging.
Bedside detection of intracranial midline shift using portable magnetic resonance imaging.
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DOI：
10.1038/s41598-021-03892-7
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发表时间：
2022-01-07
影响因子：
4.6
通讯作者：
Kundu P
中科院分区：
文献类型：
--
作者：
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
神经影像学是评估脑损伤患者占位效应的关键。然而，运送到成像室对重症患者来说是一个挑战。我们评价了使用低磁场便携式MRI（pMRI）评估中线移位（MLS）。在这项观察性研究中，对耶鲁纽黑文医院神经科学重症监护室收治的卒中患者进行了0.064 T pMRI检查。在pMRI检查和当地可用和可获得的标准治疗成像检查（CT或MRI）上获得二分（存在或不存在）和连续MLS测量值。我们评价了pMRI和标准治疗测量之间的一致性。此外，我们评估了基于pMRI的MLS与功能结局（改良兰金量表）之间的关系。最终研究共纳入102例患者（48例缺血性卒中; 54例颅内出血）。pMRI和标准治疗测量值之间存在显著一致性（二分，κ = 0.87;连续，ICC = 0.94）。低场pMRI识别MLS的灵敏度为0.93，特异性为0.96。此外，pMRI MLS评估预测出院时临床结局较差（二分：校正OR 7.98，95% CI 2.07-40.04，p = 0.005;连续：校正OR 1.59，95% CI 1.11-2.49，p = 0.021）。低场pMRI可作为检测占位效应的有价值的床边工具。
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.
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影响因子：
7.6
作者：
Liao CC;Chen YF;Xiao F
通讯作者：
Xiao F
影响因子：
16.6
作者：
Mazurek MH;Cahn BA;Yuen MM;Prabhat AM;Chavva IR;Shah JT;Crawford AL;Welch EB;Rothberg J;Sacolick L;Poole M;Wira C;Matouk CC;Ward A;Timario N;Leasure A;Beekman R;Peng TJ;Witsch J;Antonios JP;Falcone GJ;Gobeske KT;Petersen N;Schindler J;Sansing L;Gilmore EJ;Hwang DY;Kim JA;Malhotra A;Sze G;Rosen MS;Kimberly WT;Sheth KN
通讯作者：
Sheth KN
影响因子：
8.3
作者：
Broocks, Gabriel;Flottmann, Fabian;Kemmling, Andre
通讯作者：
Kemmling, Andre
影响因子：
2.9
作者：
Grunwald, Iris Quasar;Ragoschke-Schumm, Andreas;Fassbender, Klaus
通讯作者：
Fassbender, Klaus
影响因子：
2.9
作者：
Barber, PA;Demchuk, AM;Krieger, D
通讯作者：
Krieger, D