Isabel Fragata1, Marta Alves2, Ana Luísa Papoila2, Ana Paiva Nunes2, Patrícia Ferreira2, Nuno Canto-Moreira2, Patrícia Canhão2. 1. From the Neuroradiology Department, Centro Hospitalar Lisboa Central, Portugal (I.F.); Centro de Investigação (M.A., A.L.P.), and Unidade Cérebro-Vascular (A.P.N., P.F.), Centro Hospitalar Lisboa Central, Portugal; NOVA Medical School/Faculdade de Ciências Médicas, Lisbon, Portugal (A.L.P.); Radiology Department, Uppsala Universitet Medicinska Fakulteten, Sweden (N.C.M.); and Neurology Department, Centro Hospitalar Lisboa Norte, Portugal and Universidade de Lisboa, Faculdade de Medicina, Instituto de Medicina Molecular, Portugal (P.C.). isabelfragata@gmail.com. 2. From the Neuroradiology Department, Centro Hospitalar Lisboa Central, Portugal (I.F.); Centro de Investigação (M.A., A.L.P.), and Unidade Cérebro-Vascular (A.P.N., P.F.), Centro Hospitalar Lisboa Central, Portugal; NOVA Medical School/Faculdade de Ciências Médicas, Lisbon, Portugal (A.L.P.); Radiology Department, Uppsala Universitet Medicinska Fakulteten, Sweden (N.C.M.); and Neurology Department, Centro Hospitalar Lisboa Norte, Portugal and Universidade de Lisboa, Faculdade de Medicina, Instituto de Medicina Molecular, Portugal (P.C.).
Abstract
BACKGROUND AND PURPOSE: Diffusion tensor imaging (DTI) parameters are markers of cerebral lesion in some diseases. In patients with acute subarachnoid hemorrhage (SAH), we investigated whether DTI parameters measured at <72 hours might be associated with delayed cerebral ischemia (DCI) and with poor functional outcome at 3 months (modified Rankin Scale score ≥3). METHODS: DTI was performed in a prospective cohort of 60 patients with nontraumatic SAH at <72 hours. Association of fractional anisotropy and apparent diffusion coefficient values at <72 hours with the occurrence of DCI and outcome at 3 months was evaluated with logistic regression models, adjusting for known predictors of prognosis. RESULTS: At <72 hours after SAH, fractional anisotropy values at the cerebellum were associated with DCI occurrence (78% less odds of DCI for each 0.1 increase in fractional anisotropy; P=0.019). Early apparent diffusion coefficient values were not associated with DCI. After adjusting for confounding variables, an increase of 10 U in apparent diffusion coefficient at the frontal centrum semiovale corresponded to 15% increased odds of poor outcome (P=0.061). CONCLUSIONS: DTI parameters at <72 hours post-SAH are independently associated with the occurrence of DCI and functional outcome. These preliminary results suggest the role of DTI parameters as surrogate markers of prognosis in nontraumatic SAH.
BACKGROUND AND PURPOSE: Diffusion tensor imaging (DTI) parameters are markers of cerebral lesion in some diseases. In patients with acute subarachnoid hemorrhage (SAH), we investigated whether DTI parameters measured at <72 hours might be associated with delayed cerebral ischemia (DCI) and with poor functional outcome at 3 months (modified Rankin Scale score ≥3). METHODS: DTI was performed in a prospective cohort of 60 patients with nontraumatic SAH at <72 hours. Association of fractional anisotropy and apparent diffusion coefficient values at <72 hours with the occurrence of DCI and outcome at 3 months was evaluated with logistic regression models, adjusting for known predictors of prognosis. RESULTS: At <72 hours after SAH, fractional anisotropy values at the cerebellum were associated with DCI occurrence (78% less odds of DCI for each 0.1 increase in fractional anisotropy; P=0.019). Early apparent diffusion coefficient values were not associated with DCI. After adjusting for confounding variables, an increase of 10 U in apparent diffusion coefficient at the frontal centrum semiovale corresponded to 15% increased odds of poor outcome (P=0.061). CONCLUSIONS: DTI parameters at <72 hours post-SAH are independently associated with the occurrence of DCI and functional outcome. These preliminary results suggest the role of DTI parameters as surrogate markers of prognosis in nontraumatic SAH.
Authors: Anniina H Autio; Juho Paavola; Joona Tervonen; Maarit Lång; Terhi J Huuskonen; Jukka Huttunen; Virve Kärkkäinen; Mikael von Und Zu Fraunberg; Antti E Lindgren; Timo Koivisto; Juha E Jääskeläinen; Olli-Pekka Kämäräinen Journal: Acta Neurochir (Wien) Date: 2021-02-25 Impact factor: 2.216