Abstract 89: Portable, Low-Field Magnetic Resonance Imaging: Determining Mismatch Following Acute Ischemic Stroke

• DOI: 10.1161/str.55.suppl_1.89
• Publication Date: 2024-02-01T10:11:28Z
• Authors: Annabel Sorby-Adams; Jennifer Guo; Riana Schleicher; Mercy Mazurek; Steven Baldassano; Sam Payavbash; Gordon Sze; Joseph Schindler; Adam de Havenon; Joshua Goldstein; Pamela Schaefer; Julia Zabinska; Dheeraj Lalwani; Charles Wira; Charles Matouk; Vivien Lee; Keith Muir; Shahid Nimjee; Nandor Pinter; Adnan Siddiqui; John Kirsch; Juan Eugenio Igle...; Matthew Rosen; Kevin Sheth; W. Taylor Kimberly
• Keywords: Stroke; Acute stroke

Background and Aims: Treatment options for acute ischemic stroke (AIS) are uniquely dependent on the time of onset. Intravenous thrombolysis must be administered within 4.5 hours symptoms commencing, yet a subset patients wake-up with onset is unknown. Mismatch between fluid-attenuated inversion recovery (FLAIR) diffusion-weighted imaging (DWI) MRI can used to qualify strokes thrombolysis. This has been shown lead improved functional outcomes in multicenter trials (WAKE-UP, MR-WITNESS). However, access barrier differential diagnosis subsequent treatment. Recent advances portable, low-field (LF-MRI) offer solution increase technologies circumvent limitations conventional systems. As such, this pilot study, we sought establish utility portable LF-MRI identify DWI-FLAIR mismatch following AIS. Methods: Patients AIS presenting Emergency Department or Intensive Care Unit Yale New Haven Hospital Massachusetts General from January 2020 June 2023 underwent DWI FLAIR acquisition 0.064T (Hyperfine Research Inc.) at <4.5 ( n =7), 4.5-6 6-48 =110) since last known well (LKW). Conventional high-field (HF) MR images were acquired 72 LF-MRI. HF-DWI co-registered LF-FLAIR hyperintense lesion segmented superimposed FLAIR. The segmentation was mirrored contralateral hemisphere signal intensity ratio (SIR). Results: SIR LKW 0.98±0.08. cases 1.34±0.33. Cases produced 1.56±0.36. significantly less than that observed >6 p =0.03). Conclusion: study demonstrates capable distinguishing hyperacute later using SIR. Future research needed larger cohort determine if technology guide setting stroke.