Qualitative and quantitative analysis of diffusion-weighted brain MR imaging in comatose survivors after cardiac arrest
- 1 November 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Neuroradiology
- Vol. 62 (11), 1361-1369
- https://doi.org/10.1007/s00234-020-02460-6
Abstract
Purpose The aim of this study is to compare a qualitative and a quantitative assessment of brain diffusion-weighted imaging (DWI) in predicting outcome of comatose patients after cardiac arrest (CA). Methods Two observers used a scoring template to analyze the DWI of 75 patients. A total of 13 regions were scored from 0 to 3 (0 = normal, 1 = probably normal, 2 = probably abnormal, 3 = definitely abnormal). The total cerebral cortex (TCC), the total deep grey nuclei (TDGN), the total brain stem, the total cerebellum, and the total brain score were calculated. Intra- and inter-observer variability were tested. The mean whole brain apparent diffusion coefficient (ADC) values and percentage of voxels below a specific ADC value cut-off were calculated. The data were correlated with clinical outcome (cerebral performance category score after 180 days, dichotomized in a score 1-2 with favorable outcome and score 3-5 with unfavorable outcome) using ROC analysis. Results Intra-observer variability was excellent for the TCC score (ICC 0.95 and 0.86) and the TDGN score (ICC 0.89 and 0.75). Inter-observer variability was good to excellent for total cerebral cortex score and total deep grey nuclei score in both the first (ICC 0.78 and 0.69) and third (ICC 0.86 and 0.83) image assessment. TCC and TDGN score show the best correlation with clinical outcome (highest AUC values 0.87 and 0.87). Quantitative parameters did not show good correlation with clinical outcome (AUC values 0.57 and 0.60). Conclusion A qualitative assessment of brain DWI using a scoring template provides useful data regarding patient outcome while quantitative data appeared less reliable.This publication has 17 references indexed in Scilit:
- Repeated diffusion weighted imaging in comatose cardiac arrest patients with therapeutic hypothermiaResuscitation, 2015
- Multi-Center Study of Diffusion-Weighted Imaging in Coma After Cardiac ArrestNeurocritical Care, 2015
- Prognostic Value of A Qualitative Brain MRI Scoring System After Cardiac ArrestJournal of Neuroimaging, 2014
- Epidemiology and management of cardiac arrest: What registries are revealingBest Practice & Research Clinical Anaesthesiology, 2013
- Diffusion Tensor Imaging to Predict Long-term Outcome after Cardiac ArrestAnesthesiology, 2012
- Clinical MRI Interpretation for Outcome Prediction in Cardiac ArrestNeurocritical Care, 2012
- Temporal and Spatial Profile of Brain Diffusion-Weighted MRI After Cardiac ArrestStroke, 2010
- Diffusion-weighted magnetic resonance imaging for predicting the clinical outcome of comatose survivors after cardiac arrest: a cohort studyCritical Care, 2010
- Prognostic value of brain diffusion‐weighted imaging after cardiac arrestAnnals of Neurology, 2009
- Neurological and functional status following cardiac arrest: Method and tool utilityResuscitation, 2008