Low-Field, Portable Magnetic Resonance Imaging at the Bedside to Assess Brain Injury in Patients with Severe COVID-19

Objective: To obtain neuroimaging on patients with COVID-19 using a low-field, portable magnetic resonance imaging (MRI) device. Background: Neuroimaging is a key step in the clinical evaluation of brain injury. Conventional MRI systems operate at high-strength magnetic fields (1.5–3T) that require patient transportation to access-controlled environments. During the COVID-19 pandemic, critically ill patients have had limited neuroimaging due to infection control and safety concerns. We report neuroimaging in patients with severe COVID-19 using a portable MRI device. Design/Methods: A 64mT point-of-care (POC) MRI was used to acquire neuroimaging in Yale New Haven Hospital ICUs from April 2020 through August 2020. COVID-19 patients with neurological symptoms and no MRI contraindications were scanned. Exams were acquired using a standard 110V/15A power outlet. Hospital rooms included vital signs monitors, ventilators, dialysis machines, and intravenous infusion pumps. Images were acquired by trained research staff, without the need for an MRI technician. POC MRI exams were interpreted by two board-certified physicians (one neuroradiologist and one neurologist). Results: POC MRI exams were obtained on 22 ICU COVID-19 patients (19% female, ages 42–74 years, 86% mechanically ventilated). Glasgow Coma Scale and Richmond Agitation-Sedation Scale at time of scan were 7±3 and −3±2, respectively. T1-weighted (T1W), T2-weighted (T2W), fluid-attenuated inversion recovery (FLAIR), and diffusion-weighted imaging (DWI) sequences were obtained for all patients. Axial scan times were 4:54 minutes, 7:03 minutes, 9:31 minutes, and 9:04 minutes, respectively. Examination time was 35:40 minutes. Abnormal neuroimaging findings were observed in 10 patients: intracranial hemorrhage (n=2), cerebral infarction (n=4), diffuse cerebral edema (n=1), and leukoencephalopathy (n=3). The device did not interfere with ICU equipment, and no significant adverse events occurred. Conclusions: We report the acquisition of neuroimaging using a low-field, portable MRI at the bedside of patients with severe COVID-19. This approach may hold promise for bedside assessment of neurological injury in settings with imaging access constraints. Disclosure: Miss Mazurek has nothing to disclose. Mr. Yuen has nothing to disclose. Mr. Cahn has nothing to disclose. Matthew Rosen has received stock or an ownership interest from Hyperfine Research. Matthew Rosen has received stock or an ownership interest from BlinkAI. Matthew Rosen has received stock or an ownership interest from Vizma Life Sciences. Matthew Rosen has received stock or an ownership interest from Intact Data Services. The institution of Matthew Rosen has received research support from GE HealthCare. Matthew Rosen has received intellectual property interests from a discovery or technology relating to health care. Dr. Gobeske has nothing to disclose. Dr. Gilmore has nothing to disclose. Dr. Hwang has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Portola Pharmaceuticals. The institution of Dr. Hwang has received research support from Apple Pickers Foundation. The institution of an immediate family member of Dr. Hwang has received research support from National Institute of Health. The institution of an immediate family member of Dr. Hwang has received research support from American Diabetes Association. The institution of an immediate family member of Dr. Hwang has received research support from General Electric. Dr. Hwang has received publishing royalties from a publication relating to health care. Dr. Hwang has received personal compensation in the range of $5,000-$9,999 for serving as a Principal Investigator with Society of Critical Care Medicine. Dr. Hwang has a non-compensated relationship as a Board of Directors with Neurocritical Care Society that is relevant to AAN interests or activities. Dr. Kaddouh has nothing to disclose. Dr. Kim has nothing to disclose. Dr. Falcone has nothing to disclose. Dr. Petersen has received research support from NIH. The institution of Jonathan Siner has received research support from NHLBI. The institution of Dr. Spudich has received research support from NIH. Gordon Sze has nothing to disclose. Dr. Kimberly has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for NControl Therapeutics. Dr. Kimberly has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. The institution of Dr. Kimberly has received research support from Biogen. The institution of Dr. Kimberly has received research support from NControl Therapeutics. Dr. Kimberly has received intellectual property interests from a discovery or technology relating to health care. Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell. Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Zoll. Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NControl. The institution of Dr. Sheth has received research support from Biogen. The institution of Dr. Sheth has received research support from Novartis. The institution of Dr. Sheth has received research support from Bard. The institution of Dr. Sheth has received research support from Hyperfine. Dr. Sheth has received intellectual property interests from a discovery or technology relating to health care.