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Published on: August 14, 2019
Prognostic value of brain diffusion-weighted imaging after cardiac arrest
Christine A C Wijman1, Michael Mlynash, Anna Finley Caulfield
1Stanford Stroke Center, Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, CA 94304, USA. cwijman@stanford.edu
Annals of Neurology
|April 29, 2009
Summary
Brain diffusion-weighted MRI (DWI) shows promise for predicting outcomes in comatose cardiac arrest survivors. This imaging technique offers improved sensitivity and specificity compared to traditional neurological exams.
Area of Science:
- Neurology
- Radiology
- Critical Care Medicine
Background:
- Outcome prediction for comatose survivors of cardiac arrest is challenging.
- Brain diffusion-weighted magnetic resonance imaging (DWI) is a potential tool for early prognostication.
Observation:
- 86% of patients underwent brain DWI, with 51 patients and 62 scans included in the analysis.
- Specific apparent diffusion coefficient (ADC) thresholds on DWI effectively differentiated between survival and mortality groups.
Findings:
- ADC thresholds between 650-700 x 10(-6) mm(2)/sec distinguished between poor and good outcomes (p < 0.001).
- DWI between 49-108 hours post-arrest improved poor outcome prediction sensitivity by 38% with 100% specificity compared to 72-hour neurological exams (p = 0.021).
Implications:
- Quantitative DWI is a feasible and valuable prognostic adjunct in comatose postcardiac arrest survivors.
- This advanced imaging technique can enhance the accuracy of neurological outcome prediction.
