How viable is point-of-care MRI?

Wednesday, November 29 | 3:40 p.m.-3:50 p.m. | W7-SSNR12-5 | Room E353B 

Is point-of-care MRI a viable tool for critically ill patients? The answer is yes, according to research to be presented Wednesday afternoon.

Point-of-care MRI is a promising tool for treating critically ill patients who can't be transported to the imaging suite, wrote a team led by presenter Brian Gerard Yep, MD, of the University of California, Irvine (UCI) Medical Center in Orange, CA.

"This technology is promising in critically ill patients too unstable to transport where early MRI access is critical for improved survival and better patient outcomes," the group explained.

The technology allows for bedside low-field brain MR imaging – an application that could prove useful in a neurocritical care setting, the researchers noted.

"Early detection of ischemia, hemorrhage, or increased intracranial pressure can be valuable in the management of critically ill patients," they wrote.

Yep and colleagues conducted a study that assessed the use of a 64-mTesla point-of-care MRI system in UCI Medical Center's neuroscience ICU department. The team collected data from exams performed between September 2022 and February 2023, comparing the point-of-care device to fixed MRI and CT systems; 21 point-of-care MRI scans were compared with preceding CT exams and with a follow-up 1.5-tesla or 3-tesla MRI exam within 72 hours. The group assessed the different scanners' turnaround times and any exam limitations.

The study included a total of 22 patients who underwent point-of-care MRI; of these 19 also underwent CT imaging, and of these 19, five underwent an additional MRI exam on a traditional system.

The group found the following:

  • Point-of-care MRI confirmed all findings from preceding CT exams.
  • Of patients who had undergone a preceding CT, point-of-care MRI detected acute infarct in six (32%), intracerebral hemorrhage in nine (47%), and mass effect in eight (42%).
  • The five MRI exams performed on fixed systems did not identify any additional findings compared to the point-of-care device.
  • Median point-of-care MRI scan time was 43 minutes; time to image was 68 minutes; and turnaround time (that is, order time to scan completion) was 123 minutes.

"Point-of-care MRI gives the advantage of increased speed and convenience of bedside detection of acute intracranial injury, including … the ability to image critically ill patients who are too unstable to transport out of the neuroscience ICU for a CT exam," Yep and colleagues concluded.

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