Abstract
OBJECTIVE Clinical outcome in nontraumatic subarachnoid hemorrhage (SAH) is multifactorial and difficult to predict. Diffusion tensor imaging (DTI) findings are a prognostic marker in some diseases such as traumatic brain injury. The authors hypothesized that DTI parameters measured in the subacute phase of SAH can be associated with a poor clinical outcome. METHODS Diffusion tensor imaging was prospectively performed in 54 patients at 8-10 days after nontraumatic SAH. Logistic regression analysis was performed to evaluate the association of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values with a poor clinical outcome (modified Rankin Scale score ≥ 3) at 3 months. RESULTS At 8-10 days post-SAH, after adjusting for other variables associated with a poor outcome, an increased ADC at the frontal centrum semiovale was associated with a poor prognosis (OR estimate 1.29, 95% CI 1.04-1.60, p = 0.020). Moreover, an increase of 0.1 in the FA value at the corpus callosum at 8-10 days after SAH corresponded to 66% lower odds of having a poor outcome (p = 0.002). CONCLUSIONS Decreased FA and increased ADC values in specific brain regions were independently associated with a poor clinical outcome after SAH. This preliminary exploratory study supports a potential role for DTI in predicting the outcome of SAH.
Original language | English |
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Pages (from-to) | 550-558 |
Number of pages | 9 |
Journal | Journal of neurosurgery. Spine |
Volume | 130 |
Issue number | 2 |
DOIs | |
Publication status | Published - Feb 2019 |
Keywords
- ADC
- AUC
- DCI
- DTI
- DWI
- FA
- GCS
- HH
- MRI
- PLIC
- ROC
- ROI
- SAH
- WFNS
- mRS
- subarachnoid hemorrhage
- diffusion tensor imaging
- clinical outcome
- vascular disorders