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01.07.2013 | Pediatric Original

Early diffusion-weighted magnetic resonance imaging in children after cardiac arrest may provide valuable prognostic information on clinical outcome

verfasst von: Mehdi Oualha, Pauline Gatterre, Nathalie Boddaert, Laurent Dupic, Laure De Saint Blanquat, Philippe Hubert, Fabrice Lesage, Isabelle Desguerre

Erschienen in: Intensive Care Medicine | Ausgabe 7/2013

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Abstract

Objective

We examined whether early diffusion-weighted magnetic resonance imaging (DW-MRI) abnormalities of the brain and variation of apparent diffusion coefficient (ADC) values can provide prognostic information on clinical outcome in children following cardiac arrest (CA).

Design

Retrospective study.

Setting

A 12-bed paediatric intensive care unit (PICU).

Patients

Children aged between 1 month and 18 years who had DW-MRI with ADC measurement within the first week following CA. Neurological outcomes were assessed using the Pediatric Cerebral Performance Category Scale (PCPC). Differences between the favourable (PCPC ≤3) and unfavourable (PCPC ≥4) groups were analysed with regard to clinical data, electrophysiological patterns as well as qualitative and quantitative DW-MRI abnormalities.

Results

Twenty children with a median age of 20 months (1.5–185) and a male/female sex ratio of 1.5 underwent DW-MRI after CA with a median delay of 3 days (1–7). Aetiologies of CA were (i) asphyxia (n = 10), (ii) haemodynamic (n = 5) or (iii) unknown (n = 5). With regard to DW-MRI findings, the unfavourable outcome group (n = 8) was associated with cerebral cortex (p = 0.02) and basal ganglia (p = 0.005) lesions, with a larger number of injured brain regions (p = 0.001) and a global decrease in measured ADC signal (p = 0.008). Normal DW-MRI (n = 5) was exclusively associated with the favourable outcome group (n = 12).

Conclusion

Qualitative, topographic and quantitative analysis of early DW-MRI with ADC measurement in children following CA may provide valuable prognostic information on neurological outcomes.

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Titel: Early diffusion-weighted magnetic resonance imaging in children after cardiac arrest may provide valuable prognostic information on clinical outcome
verfasst von: Mehdi Oualha
Pauline Gatterre
Nathalie Boddaert
Laurent Dupic
Laure De Saint Blanquat
Philippe Hubert
Fabrice Lesage
Isabelle Desguerre
Publikationsdatum: 01.07.2013
Verlag: Springer-Verlag
Erschienen in: Intensive Care Medicine / Ausgabe 7/2013
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-013-2930-z

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Early diffusion-weighted magnetic resonance imaging in children after cardiac arrest may provide valuable prognostic information on clinical outcome

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Objective

Design

Setting

Patients

Results

Conclusion

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