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Early Prediction of Delayed Ischemia and Functional Outcome in Acute Subarachnoid Hemorrhage: Role of Diffusion Tensor Imaging
Ctr Hosp Lisboa Cent, Dept Neuroradiol, Rua Jose Antonio Serrano, P-1150099 Lisbon, Portugal..
Ctr Hosp Lisboa Cent, Ctr Invest, Lisbon, Portugal..
Ctr Hosp Lisboa Cent, Ctr Invest, Lisbon, Portugal.;Ctr Hosp Lisboa Cent, Unidade Cerebrovasc, Lisbon, Portugal.;NOVA Med Sch, Fac Ciencias Med, Lisbon, Portugal..
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2017 (English)In: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 48, no 8, p. 2091-2097Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
2017. Vol. 48, no 8, p. 2091-2097
Keywords [en]
anisotropy, cerebral ischemia, diffusion tensor imaging, prognosis, subarachnoid hemorrhage
National Category
Cardiac and Cardiovascular Systems Neurology
Identifiers
URN: urn:nbn:se:uu:diva-332921DOI: 10.1161/STROKEAHA.117.016811ISI: 000406128300034PubMedID: 28667021OAI: oai:DiVA.org:uu-332921DiVA, id: diva2:1157703
Available from: 2017-11-16 Created: 2017-11-16 Last updated: 2017-11-16Bibliographically approved

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