Diffusion Tensor Imaging to Predict Long-term Outcome after Cardiac Arrest

• DOI: 10.1097/aln.0b013e318275148c
• Publication Date: 2012-11-08T09:00:29Z
• Authors: Charles-Edouard Luyt; Damien Galanaud; Vincent Perlbarg; Audrey Vanhaudenh...; Robert D. Stevens; Rajiv Gupta; Hortense Besancenot; Alexandre Krainik; Gérard Audibert; Alain Combes; Jean Chastre; Habib Benali; Steven Laureys; Louis Puybasset
• Keywords: Adult; Male; Time Factors; [INFO.INFO-IM] Computer Science [cs]/Medical Imaging; 610; Brain; Pilot Projects; Middle Aged; Nerve Fibers, Myelinated; Heart Arrest; 3. Good health; 03 medical and health sciences; Diffusion Tensor Imaging; Treatment Outcome; 0302 clinical medicine; Predictive Value of Tests; 616; [INFO.INFO-IM]Computer Science [cs]/Medical Imaging; Humans; Female; Prospective Studies; Aged; Follow-Up Studies

Prognostication in comatose survivors of cardiac arrest is a major clinical challenge. The authors' objective was to determine whether an assessment with diffusion tensor imaging, brain magnetic resonance imaging sequence, increases the accuracy 1 yr functional outcome prediction survivors.Prospective, observational study two intensive care units. Fifty-seven underwent imaging. Fractional anisotropy (FA), value, measured predefined white matter regions, and apparent coefficient assessed grey regions. Prediction unfavorable at compared using four prognostic models: FA global, selected, coefficient, classifiers.Of 57 patients included study, 49 had 12 months. Areas under receiver operating characteristic curve (95% CI) predict for clinical, models were 0.92 (0.82-0.98), 0.96 (0.87-0.99), 0.78 (0.65-0.88), 0.86 (0.74-0.94), respectively. selected model best overall predicting outcome, score above 0.44 having 94% CI, 83-99%) sensitivity 100% 63-100%) specificity outcome.Quantitative indicates that damage widespread after arrest. A based on values tracts seems accurately outcome. These preliminary results need be confirmed larger population.