A GROUNDBREAKING study has demonstrated that the 0.23-Tesla (0.23-T) MRI using a novel haematoma-enhanced inversion recovery (HEIR) sequence has a 100% accuracy in differentiating between acute ischaemic stroke (AIS) and intracerebral haemorrhage (ICH) within 24 hours of symptom onset, in a combined experimental and clinical study.
This study aimed to evaluate the diagnostic accuracy of a 0.23-T low-field MRI in stroke detection, addressing the critical need for timely differentiation between AIS and ICH. The research focused on developing a rapid, cost-effective alternative to high-field MRI for emergency stroke diagnosis. Employing the novel HEIR sequence alongside diffusion-weighted imaging (DWI), the study investigated its application in experimental models and confirmed its utility in clinical settings.
A pig model of ICH and AIS was scanned hourly using the 0.23-T MRI, enabling adjustments to imaging parameters, with the inversion time set at 800 ms to optimise detection of ICH. Subsequently, the 0.23-T MRI was tested in 30 patients with AIS and 30 with ICH, with prior confirmation of diagnoses using 3T-MRI or CT. AIS was characterised by hyperintensity on DWI and isointensity on HEIR, while ICH presented as hyperintensity on both DWI and HEIR. Images were independently reviewed by two blinded raters. The 0.23-T MRI achieved 100% accuracy in diagnosing all cases, with no adverse events reported, confirming its reliability and precision in identifying AIS and ICH.
This study highlights the potential of the 0.23-T MRI as a transformative tool in stroke imaging. With its ability to deliver accurate diagnoses swiftly and at reduced costs, it could enhance stroke care by streamlining imaging processes in emergency settings. The development of this novel imaging approach addresses a significant clinical gap, allowing for the rapid initiation of appropriate treatment. Future multicentre studies are essential to validate these findings across diverse patient populations. If widely implemented, the 0.23-T MRI could revolutionise stroke diagnostics, making advanced imaging accessible in resource-limited settings.
Katrina Thornber, EMJ
Reference
Xie W et al. 0.23-Tesla MRI to differentiate between ischaemic and haemorrhagic strokes within 24 hours of onset: a combined experimental–clinical study. Stroke and Vascular Neurology. 2024;svn-2024-003592.
