Related Experiment Video
Updated: Mar 6, 2026
A Bedside, Single Burr Hole Approach to Multimodality Monitoring in Severe Brain Injury
Published on: March 26, 2019
Utility of Low-Field Portable MRI in Neurosurgical ICU Patients Who Are Mechanically Ventilated: A Single-Center
Wei Rao1, Jin-Long Mao1, Luo-Kai Huang-Fu1
1From the Senior Department of Neurosurgery, the First Medical Center of PLA General Hospital, Beijing.
Background And Purpose:
Conventional MRI is frequently inaccessible to neurosurgical patients who are critically ill, especially those on mechanical ventilation, because of stringent safety requirements and high-shielding needs. Low-field portable MRI presents a promising alternative by enabling bedside imaging. Nonetheless, its clinical effectiveness and diagnostic precision in these patients require further investigation.
Materials And Methods:
This retrospective, single-center study included all patients who are mechanically ventilated who underwent low-field portable MRI between December 2022 and July 2024 in the neurosurgical intensive care unit. Utilizing a 0.23T low-field portable MRI (LF-pMRI) device approved by the National Medical Products Administration of China, imaging parameters and patient preparation protocols were standardized. Two senior neurosurgical intensivists and a blinded, independent neuroradiologist analyzed the MRI scans.
Results:
Over a 20 months, 60 LF-pMRI examinations were performed on 50 patients who are mechanically ventilated, with no adverse events reported. The cohort consisted of 26 women and 24 men, with a mean age of 49.2 ± 18.7 years. LF-pMRI exhibited high sensitivity, identifying acute brain injuries in 96.7% of cases, predominantly ischemic infarctions (48.3%), followed by intracranial hemorrhage (21.7%) and infections (8.3%). Compared with CT, LF-pMRI showed superior sensitivity for postoperative infarctions (14 versus 2 detections) despite longer preparation (8.8 versus 5.6 minutes, P < .05). The system achieved 92.3% sensitivity (95% CI: 64.0-99.8) and 85.7% specificity (95% CI: 42.1-99.6) for infarction detection. LF-pMRI findings directly altered management in 38% of cases, prompting surgical interventions or therapy adjustments.
Conclusions:
LF-pMRI serves as a feasible and secure technique for bedside neuromonitoring in patients who are mechanically ventilated. Its proficiency in detecting critical brain abnormalities underscores its potential as a valuable complement to conventional MRI in the neurosurgical intensive care unit. Future research should concentrate on enhancing image quality and broadening its diagnostic applications.
Insights
Low-field portable MRI (LF-pMRI) is a safe and effective bedside tool for critically ill neurosurgical patients on mechanical ventilation. This technology accurately detects acute brain injuries, influencing patient management and complementing conventional MRI in intensive care units.
Area of Science:
- Neurosurgery
- Radiology
- Intensive Care Medicine
Background:
- Conventional MRI is often inaccessible for critically ill neurosurgical patients requiring mechanical ventilation due to safety and shielding requirements.
- Low-field portable MRI (LF-pMRI) offers a potential solution for bedside neuroimaging in this patient population.
- The clinical utility and diagnostic accuracy of LF-pMRI in mechanically ventilated neurosurgical patients require thorough evaluation.
Purpose of the Study:
- To assess the feasibility, safety, and diagnostic performance of low-field portable MRI (LF-pMRI) for bedside neuromonitoring in mechanically ventilated neurosurgical patients.
- To compare the sensitivity of LF-pMRI with CT for detecting postoperative infarctions.
- To determine the impact of LF-pMRI findings on clinical management decisions.
Main Methods:
- A retrospective, single-center study involving mechanically ventilated patients who underwent LF-pMRI between December 2022 and July 2024.
- Utilized a 0.23T LF-pMRI device with standardized imaging parameters and patient preparation.
- MRI scans were analyzed by neurosurgical intensivists and an independent neuroradiologist.
Main Results:
- 60 LF-pMRI examinations were performed on 50 mechanically ventilated patients without adverse events.
- LF-pMRI demonstrated high sensitivity (96.7%) in detecting acute brain injuries, including ischemic infarctions (48.3%), intracranial hemorrhage (21.7%), and infections (8.3%).
- LF-pMRI showed superior sensitivity for postoperative infarctions compared to CT and directly altered management in 38% of cases.
Conclusions:
- Low-field portable MRI (LF-pMRI) is a feasible and safe bedside neuromonitoring technique for mechanically ventilated neurosurgical patients.
- LF-pMRI effectively detects critical brain abnormalities, serving as a valuable adjunct to conventional MRI in the neurosurgical intensive care unit.
- Future research should focus on improving LF-pMRI image quality and expanding its diagnostic applications.
Related Concept Videos
01:24Magnetic Resonance Imaging
01:30Radiological Investigation II: MRI and Ventilation Perfusion Scan
Magnetic Resonance Imaging (MRI) and Ventilation Perfusion Scans are two radiological investigations that offer detailed diagnostic images of the body, particularly lung structures.
MRI
MRI uses magnetic fields and radiofrequency signals to distinguish between normal and abnormal tissues. This technology provides a more detailed diagnostic image than CT scans, enabling it to characterize pulmonary nodules, stage bronchogenic carcinoma, and evaluate inflammatory activity in...
01:21Imaging Studies for Cardiovascular System IV: CMRI