Cerebral small vessel disease (SVD) is the most common age-related brain pathology. Magnetic resonance imaging (MRI) is the reference standard for identifying SVD biomarkers, including white matter hyperintensity, recent small subcortical infarcts, lacunes, perivascular spaces, cerebral microbleeds, and cortical superficial siderosis. However, SVD is usually detected only when patients undergo conventional high-field MRI, limiting early identification, longitudinal monitoring, and equitable access to brain health evaluation. Low-field portable MRI systems (<0.1T) offer point-of-care acquisition with reduced infrastructure requirements and have demonstrated concordance with conventional MRI for multiple acute brain pathologies. We review the emerging evidence for portable MRI-based detection of SVD features, with an emphasis on white matter hyperintensity. Future portable MRI work on SVD should prioritize longitudinal validation, standardized reporting, and integration into pragmatic vascular prevention trials.
A. de Havenon, Matthew J Huentelmen· Stroke· 0 citations
Neurological deterioration is a frequent and clinically significant challenge in patients with acute stroke admitted to neurocritical care units, where timely neuroimaging is essential but access to advanced imaging may be limited by patient instability and logistical constraints. Low-field magnetic resonance imaging (LF-MRI) has recently emerged as a novel approach to extend MRI capability into critical care environments. This topic review synthesizes current evidence on the feasibility, safety, and evolving clinical applications of LF-MRI in neurocritical care stroke. Existing studies demonstrate its utility in diagnostic clarification, longitudinal monitoring of brain injury, and detection of selected secondary complications. Key applications include intracerebral hemorrhage detection and volumetric assessment, quantification of midline shift, ventricular monitoring, evaluation of infarct evolution and cerebral edema, and assessment of unexplained neurological deterioration. Beyond these applications, LF-MRI offers a unique opportunity to support repeated imaging during periods when neurological examination is unreliable or limited. LF-MRI should be viewed as a complementary imaging modality rather than a replacement for computed tomography or conventional high-field MRI. Future advances in sequence development, workflow integration, and rigorously validated artificial intelligence-assisted quantitative tools are expected to further define its role in risk stratification, time-sensitive decision-making, and longitudinal neurocritical care pathways. As access to portable imaging expands, LF-MRI has the potential to reshape neuroimaging strategies in critically ill patients with stroke.
Lina Zheng, Z. Law, X. Nie et al.· Stroke· 0 citations