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Abstract Details

Performance and Yield of MRI in Patients with Deep Intracerebral Hemorrhage
Neuro Trauma, Critical Care, and Sports Neurology
P3 - Poster Session 3 (5:30 PM-6:30 PM)
4-001
To identify factors associated with (1) MRI utilization and (2) diagnostic yield of MRI in deep ICH. 
The performance and utility of magnetic resonance imaging (MRI) in patients with deep intracerebral hemorrhage (ICH) is unclear. There is a need to clarify the role of MRI in the diagnostic workup for deep ICH. 

We retrospectively reviewed the utilization and yield of MRI for patients with deep ICH at three large academic medical centers. 
Of 118 patients with deep ICH, 58 (49%) had an MRI and 10 of the 58 (17%) MRIs were diagnostic for ICH etiology or showed other relevant vascular pathology (ischemic stroke (4), vascular lesion (3), tumor (2), and cortical microhemorrhages consistent with amyloid/cavernomas (2)). Patients who had an MRI were more likely to also have vessel imaging (59% vs. 41%; P=0.016). Utilization and yield of MRI were higher in patients with lower NIHSS (median (IQR) of 10 (3-18) vs. 13 (5-26); P=0.04 and 3 (1-15) vs. 11 (4-18); P=0.13, respectively). MRI yield was significantly higher in patients without a history of smoking (26% vs. 4%; P=0.04), despite no difference in rates of utilization. There was no significant relationship between MRI use or yield and age, sex, race, admission or peak blood pressure, antiplatelet or anticoagulant use, initial platelet count or INR, bleed volume, history of cancer, history of hypertension or history of ICH. 
The use of MRI in patients with deep ICH is variable, but practitioners are more likely to order MRIs in patients with deep ICH that have a better clinical status and in patients for whom they are also obtaining vessel imaging. MRIs are more likely to explain deep ICH etiology in individuals without a significant smoking history.  
Authors/Disclosures
Luke Moretti
PRESENTER 		The institution of Mr. Moretti has received research support from the NIH.
Jennifer A. Frontera, MD (NYU Langone Health) Dr. Frontera has received personal compensation in the range of $500-$4,999 for serving as a Consultant for FirstKindMedical. Dr. Frontera has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Physician 好色先生 Resource. The institution of Dr. Frontera has received research support from NIH. The institution of Dr. Frontera has received research support from Alexion. Dr. Frontera has received publishing royalties from a publication relating to health care.
Aaron Lord, MD (NYU Langone-Brooklyn) Dr. Lord has nothing to disclose.
Jose L. Torres, MD (NYU) Dr. Torres has nothing to disclose.
Koto Ishida, MD, FAAN (NYU) Dr. Ishida has received publishing royalties from a publication relating to health care.
Barry M. Czeisler, MD, MS, MHPE, FAAN (Providence Specialty Medical Group) Dr. Czeisler has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for NeuroStat Consulting LLC. Dr. Czeisler has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for NeuroStat Consulting LLC. Dr. Czeisler has stock in Brainspace. Dr. Czeisler has received publishing royalties from a publication relating to health care.
Ariane Lewis, MD, FAAN (NYU Langone Medical Center) Dr. Lewis has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Seminars in Neurology. Dr. Lewis has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of Clinical Neuroscience.