BACKGROUND AND PURPOSE: To develop a qualitative brain magnetic resonance imaging (MRI) scoring system for comatose cardiac arrest patients that can be used in clinical practice. METHODS: Consecutive comatose postcardiac arrest patients were prospectively enrolled. Routine MR brain sequences were scored by two independent blinded experts. Predefined brain regions were qualitatively scored on the fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted imaging (DWI) sequences according to the severity of the abnormality on a scale from 0 to 4. The mean score of the raters was used. Poor outcome was defined as death or vegetative state at 6 months. RESULTS: Sixty-eight patients with 88 brain MRI scans were included. Median time from the arrest to the initial MRI was 77 hours (IQR 58-144 hours). At 100% specificity, the "cortex score" performed best in predicting unfavorable outcome with a sensitivity of 55%-60% (95% CI 41-74) depending on time window selection. When comparing the "cortex score" with historically used predictors for poor outcome, MRI improved the sensitivity for poor outcome over conventional predictors by 27% at 100% specificity. CONCLUSIONS: A qualitative MRI scoring system helps assess hypoxic-ischemic brain injury severity following cardiac arrest and may provide useful prognostic information in comatose cardiac arrest patients.
BACKGROUND AND PURPOSE: To develop a qualitative brain magnetic resonance imaging (MRI) scoring system for comatose cardiac arrestpatients that can be used in clinical practice. METHODS: Consecutive comatose postcardiac arrestpatients were prospectively enrolled. Routine MR brain sequences were scored by two independent blinded experts. Predefined brain regions were qualitatively scored on the fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted imaging (DWI) sequences according to the severity of the abnormality on a scale from 0 to 4. The mean score of the raters was used. Poor outcome was defined as death or vegetative state at 6 months. RESULTS: Sixty-eight patients with 88 brain MRI scans were included. Median time from the arrest to the initial MRI was 77 hours (IQR 58-144 hours). At 100% specificity, the "cortex score" performed best in predicting unfavorable outcome with a sensitivity of 55%-60% (95% CI 41-74) depending on time window selection. When comparing the "cortex score" with historically used predictors for poor outcome, MRI improved the sensitivity for poor outcome over conventional predictors by 27% at 100% specificity. CONCLUSIONS: A qualitative MRI scoring system helps assess hypoxic-ischemic brain injury severity following cardiac arrest and may provide useful prognostic information in comatose cardiac arrestpatients.
Authors: Melika Hosseini; Robert H Wilson; Christian Crouzet; Arya Amirhekmat; Kevin S Wei; Yama Akbari Journal: Neurotherapeutics Date: 2020-04 Impact factor: 7.620
Authors: Alexandra S Reynolds; Xiaotao Guo; Elizabeth Matthews; Daniel Brodie; Leroy E Rabbani; David J Roh; Soojin Park; Jan Claassen; Mitchell S V Elkind; Binsheng Zhao; Sachin Agarwal Journal: Resuscitation Date: 2017-06-15 Impact factor: 5.262
Authors: D Pugin; J Hofmeister; Y Gasche; S Vulliemoz; K-O Lövblad; D Van De Ville; S Haller Journal: AJNR Am J Neuroradiol Date: 2020-05-21 Impact factor: 3.825
Authors: Samuel B Snider; David Fischer; Morgan E McKeown; Alexander Li Cohen; Frederic L W V J Schaper; Edilberto Amorim; Michael D Fox; Benjamin Scirica; Matthew B Bevers; Jong Woo Lee Journal: Neurology Date: 2022-01-11 Impact factor: 9.910
Authors: K G Hirsch; M Mlynash; I Eyngorn; R Pirsaheli; A Okada; S Komshian; C Chen; S A Mayer; J F Meschia; R A Bernstein; O Wu; D M Greer; C A Wijman; G W Albers Journal: Neurocrit Care Date: 2016-02 Impact factor: 3.210
Authors: Neill K J Adhikari; Damon C Scales; Carmen Lopez Soto; Laura Dragoi; Chinthaka C Heyn; Andreas Kramer; Ruxandra Pinto Journal: Neurocrit Care Date: 2020-02 Impact factor: 3.210