Purpose Over the years, interesting SWI abnormalities in patients from intensive care units (ICU) were observed, not attributable to a specific cause and with uncertain clinical significance. Recently, multiple SWI-hypointense foci were mentioned related to neurological complications of SARS-COV-2 infection. The purpose of the study was to describe the patterns of susceptibility brain changes in critically-ill patients who underwent mechanical ventilation and/or extracorporeal membrane oxygenation (ECMO). Methods An institutional board-approved, retrospective study was conducted on 250 ICU patients in whom brain MRI was performed between January 2011 and May 2020. Out of 48 patients who underwent mechanical ventilation/ECMO, in fifteen patients (median age 47.7 years), the presence of SWI abnormalities was observed and described. Results Microsusceptibilities were located in white-gray matter interface, in subcortical white matter (U-fibers), and surrounding subcortical nuclei in 13/14 (92,8%) patients. In 8/14 (57,1%) patients, SWI foci were seen infratentorially. The corpus callosum was affected in ten (71,4%), internal capsule in five (35,7%), and midbrain/pons in six (42,8%) patients. Conclusion We showed distinct patterns of diffuse brain SWI susceptibilities in critically-ill patients who underwent mechanical ventilation/ECMO. The etiology of these foci remains uncertain, but the association with mechanical ventilation, prolonged respiratory failure, and hypoxemia seems probable explanations.
【저자키워드】 mechanical ventilation, Brain, Extracorporeal membrane oxygenation (ECMO), Microbleeds, Magnetic resonance imaging (MRI), 【초록키워드】 Respiratory failure, susceptibility, Infection, intensive care unit, MRI, ICU, Retrospective study, extracorporeal membrane oxygenation, Hypoxemia, Patient, ECMO, etiology, patients, association, Neurological complication, median age, abnormality, foci, over, corpus, FIVE, ICU patient, nuclei, Result, described, affected, conducted, was performed, changes in, callosum, remains uncertain, subcortical, 【제목키워드】 magnetic resonance imaging, MRI, change, Critically ill patient,