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Repeated magnetic resonance imaging and cerebral performance after cardiac arrest: a pilot study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Radiology.
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2011 (English)In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 82, no 5, 549-555 p.Article in journal (Refereed) Published
Abstract [en]

AIM OF THE STUDY:

Prognostication may be difficult in comatose cardiac arrest survivors. Magnetic resonance imaging (MRI) is potentially useful in the prediction of neurological outcome, and it may detect acute ischemia at an early stage. In a pilot setting we determined the prevalence and development of cerebral ischemia using serial MRI examinations and neurological assessment.

METHODS:

Ten witnessed out-of-hospital cardiac arrest patients were included. MRI was carried out approximately 2h after admission to the hospital, repeated after 24h of therapeutic hypothermia and 96 h after the arrest. The images were assessed for development of acute ischemic lesions. Neurophysiological and cognitive tests as well as a self-reported quality-of-life questionnaire, Short Form-36 (SF-36), were administered minimum 12 months after discharge.

RESULTS:

None of the patients had acute cerebral ischemia on MRI at admission. Three patients developed ischemic lesions after therapeutic hypothermia. There was a change in the apparent diffusion coefficient, which significantly correlated with the temperature (p < 0.001). The neurophysiological tests appeared normal. The patients scored significantly better on SF 36 than the controls as regards both bodily pain (p = 0.023) and mental health (p = 0.016).

CONCLUSIONS:

MRI performed in an early phase after cardiac arrest has limitations, as MRI performed after 24 and 96 h revealed ischemic lesions not detectable on admission. ADC was related to the core temperature, and not to the volume distributed intravenously. Follow-up neurophysiologic tests and self-reported quality of life were good.

Place, publisher, year, edition, pages
2011. Vol. 82, no 5, 549-555 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-156900DOI: 10.1016/j.resuscitation.2011.01.018PubMedID: 21367511OAI: oai:DiVA.org:uu-156900DiVA: diva2:433797
Available from: 2011-08-11 Created: 2011-08-11 Last updated: 2017-12-08Bibliographically approved

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Larsson, Elna-Marie

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