Acute-stage diffusion-weighted magnetic resonance imaging for predicting outcome of poor-grade aneurysmal subarachnoid hemorrhage
Acute-stage diffusion-weighted magnetic resonance imaging for predicting outcome of poor-grade aneurysmal subarachnoid hemorrhage
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DOI：
10.1038/jcbfm.2009.264
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发表时间：
2010-06-01
影响因子：
6.3
通讯作者：
Tominaga, Teiji
中科院分区：
文献类型：
--
作者：
Sato, Kenichi;Shimizu, Hiroaki;Tominaga, Teiji
我们研究了急性期弥散加权成像（DWI）在预测低级别蛛网膜下腔出血（SAH）预后中的作用。该研究纳入了38例在发病后24小时内接受DWI的低级别SAH患者。DWI结果根据病变面积分为三组：无（N），点状（S，10 mm（2））。我们评估了术前DWI结果与临床结果之间的相关性，以及DWI异常的特征。81.6%的病例显示DWI异常（S组34.2%，A组47.3%）。N、S两组均行根治术，A组根治率为73.3%。对于那些没有再破裂的患者，N组100%、S组53.8%和A组0%获得了良好结局。在初始DWI上的异常病变（导致永久性病变）显示平均表观扩散系数与对照值的比值为0.71，显著低于可逆性病变中观察到的0.95（P< 0.01）。我们建议即使是分级较差的SAH，只要术前DWI显示没有或只有点状病变，也要进行根治性治疗。DWI可以提供一种客观的手段来估计不良等级SAH的结果。Journal of Cerebral Blood Flow & Metabolism（2010）30，1110-1120; doi：10.1038/jcbfm.2009.264; 2010年1月6日在线发表
We investigated the role of acute-stage diffusion-weighted images (DWIs) for predicting outcome of poor-grade subarachnoid hemorrhage (SAH). This study included 38 patients with poor-grade SAH who underwent DWI within 24 h after onset. DWI findings were divided into three groups on the basis of lesion area: none (N), spotty (S, 10 mm(2)). We evaluated the correlation between preoperative DWI findings and clinical outcome, and the characteristics of DWI abnormalities. DWI abnormalities were revealed in 81.6% of cases (group S 34.2%; group A 47.3%). All patients in groups N and S and 73.3% of patients in group A were treated radically. For those patients without rerupture, favorable outcomes were achieved in 100% of group N, 53.8% of group S, and 0% of group A. Abnormal lesions on initial DWI, which resulted in permanent lesions, showed a mean apparent diffusion coefficient ratio to the control value of 0.71, which was significantly lower than 0.95 observed in reversible lesions (P< 0.01). We recommend radical treatment for even poor-grade SAH as long as the preoperative DWI shows no or only spotty lesions. DWI may provide an objective means to estimate the outcome of poor-grade SAH. Journal of Cerebral Blood Flow & Metabolism (2010) 30, 1110-1120; doi: 10.1038/jcbfm.2009.264; published online 6 January 2010