Diagnostic Performance of Mobile Low‐Field
MRI
and
CT
for Acute Headache as the Isolated Clinical Manifestation in the Neurology Emergency Departmen
Xinyan Hu, Chong Han, Qianmei Jiang, Yue Suo, Wanliang Du, Zhe Zhang, Ning Wang, Bingshan Xue, Yihuai Wang, Zixiao Li, Xingquan Zhao, Hao Li, Tao Liu, Yongjun Wang, Jing Jing, Xuewei Xie ABSTRACT
Background
Headache may manifest as the sole or predominant presenting symptom of various types of acute stroke. While mobile low‐field magnetic resonance imaging (mLF‐MRI) shows promise for rapid and accurate diagnosis in the emergency department (ED), its diagnostic concordance using computed tomography (CT) as the reference standard requires clarification.
Methods
This prospective study included 199 patients who presented to the ED of Beijing Tiantan Hospital with headache within 72 h of onset, without Face‐Arm‐Speech Test (FAST) symptoms, and who underwent 0.23‐T mLF‐MRI between January and July 2024. This study evaluated the diagnostic utility of 0.23‐T mLF‐MRI in emergency patients presenting with an isolated acute headache. We specifically compared the consistency of mLF‐MRI and CT in detecting subarachnoid hemorrhage (SAH) and other causes.
Results
Of the 199 patients with headache who did not have FAST symptoms, 71 (35.68%) were diagnosed with stroke, including 60 cases of SAH and 2 patients with intracerebral hemorrhage (ICH). Notably, 9 patients presenting with headaches but without FAST symptoms were diagnosed with acute ischemic stroke. The diagnostic concordance between the fluid‐attenuated inversion recovery (FLAIR) sequence of mLF‐MRI and CT for SAH was excellent (κ = 0.99). The mLF‐MRI provided short scanning times and offered a portable, low‐power diagnostic tool.
Conclusion
For emergency patients with headaches as the initial and isolated clinical manifestation, mLF‐MRI may serve as a supplementary diagnostic imaging modality that provides additional diagnostic information in selected ED settings. mLF‐MRI, especially FLAIR sequences, demonstrated high CT‐referenced diagnostic concordance for SAH and may also detect early ischemic lesions.