Use of Magnetic Resonance Imaging in Neuroprognostication After Pediatric Cardiac Arrest: Survey of Current Practices.
Use of Magnetic Resonance Imaging in Neuroprognostication After Pediatric Cardiac Arrest: Survey of Current Practices.
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DOI：
10.1016/j.pediatrneurol.2022.06.011
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发表时间：
2022-09
影响因子：
3.8
通讯作者：
POCCA Investigators
中科院分区：
文献类型：
--
作者：
Piantino JA;Ruzas CM;Press CA;Subramanian S;Balakrishnan B;Panigrahy A;Pettersson D;Maloney JA;Vossough A;Topjian A;Kirschen MP;Doughty L;Chung MG;Maloney D;Haller T;Fabio A;Fink EL;POCCA Investigators
已经描述了使用磁共振成像（MRI）作为辅助心脏骤停（CA）后神经预测的工具，但具体适应症、时机和序列的细节尚不清楚。我们的目的是确定目前的做法，在使用脑MRI在小儿CA后的诊断。向参与三项国际研究的儿科机构分发了一份调查。调查与中心人口统计学、CA后MRI临床实践模式、神经影像学资源和MRI决策支持相关的问题。应答率为31%（44/143）。34%（15/44）的中心有临床路径，告知CA后使用MRI。50%（22/44）的受访者报告称，几乎所有CA患者都进行了MRI检查，32%（14/44）的受访者在未恢复到基线神经系统状态的患者中进行了MRI检查。据报告，神经系统检查不佳是决定MRI时间的最常见因素（91% [40/44]）。常规序列（T1、T2、液体衰减反转恢复和扩散加权成像/表观扩散系数）在97%以上的中心常规使用。不到一半的研究中心报告使用了先进的成像技术（磁共振波谱、弥散张量成像和功能性MRI）。常规脑部MRI是CA后的常见检查方法。先进的成像技术很少使用。缺乏标准化的临床路径和报告实践的可变性支持了对临床MRI研究的适应症、时间和采集方案的更高质量证据的需求。
Use of magnetic resonance imaging (MRI) as a tool to aid in neuroprognostication after cardiac arrest (CA) has been described, yet details of specific indications, timing, and sequences are unknown. We aim to define the current practices in use of brain MRI in prognostication after pediatric CA. A survey was distributed to pediatric institutions participating in three international studies. Survey questions related to center demographics, clinical practice patterns of MRI after CA, neuroimaging resources, and details regarding MRI decision support. Response rate was 31% (44 of 143). Thirty-four percent (15 of 44) of centers have a clinical pathway informing the use of MRI after CA. Fifty percent (22 of 44) of respondents reported that an MRI is obtained in nearly all patients with CA, and 32% (14 of 44) obtain an MRI in those who do not return to baseline neurological status. Poor neurological examination was reported as the most common factor (91% [40 of 44]) determining the timing of the MRI. Conventional sequences (T1, T2, fluid-attenuated inversion recovery, and diffusion-weighted imaging/apparent diffusion coefficient) are routinely used at greater than 97% of centers. Use of advanced imaging techniques (magnetic resonance spectroscopy, diffusion tensor imaging, and functional MRI) were reported by less than half of centers. Conventional brain MRI is a common practice for prognostication after CA. Advanced imaging techniques are used infrequently. The lack of standardized clinical pathways and variability in reported practices support a need for higher-quality evidence regarding the indications, timing, and acquisition protocols of clinical MRI studies.
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影响因子：
6.5
作者：
Fink EL;Berger RP;Clark RS;Watson RS;Angus DC;Panigrahy A;Richichi R;Callaway CW;Bell MJ;Mondello S;Hayes RL;Kochanek PM
通讯作者：
Kochanek PM
DOI：
10.1097/pcc.0b013e3182196a7b
发表时间：
2012-01
期刊：
Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
影响因子：
--
作者：
Abend NS;Topjian AA;Kessler SK;Gutierrez-Colina AM;Berg RA;Nadkarni V;Dlugos DJ;Clancy RR;Ichord RN
通讯作者：
Ichord RN
影响因子：
6.2
作者：
Donoghue, AJ;Nadkarni, V;Stiell, IG
通讯作者：
Stiell, IG
影响因子：
8.8
作者：
Knudson, Jarrod D.;Neish, Steven R.;Rossano, Joseph W.
通讯作者：
Rossano, Joseph W.
影响因子：
8.8
作者：
Fink EL;Berger RP;Clark RS;Watson RS;Angus DC;Richichi R;Panigrahy A;Callaway CW;Bell MJ;Kochanek PM
通讯作者：
Kochanek PM