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Stroke. 2017 Aug;48(8):2091-2097. doi: 10.1161/STROKEAHA.117.016811. Epub 2017 Jun 30.

Early Prediction of Delayed Ischemia and Functional Outcome in Acute Subarachnoid Hemorrhage: Role of Diffusion Tensor Imaging.

Author information

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.

KEYWORDS:

anisotropy; cerebral ischemia; diffusion tensor imaging; prognosis; subarachnoid hemorrhage

PMID:
28667021
DOI:
10.1161/STROKEAHA.117.016811
[Indexed for MEDLINE]

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