Acute-stage diffusion-weighted magnetic resonance imaging for predicting outcome of poor-grade aneurysmal subarachnoid hemorrhage

作者：Sato Kenichi^*; Shimizu Hiroaki; Fujimura Miki; Inoue Takashi; Matsumoto Yasushi; Tominaga Teiji

来源：Journal of Cerebral Blood Flow and Metabolism, 2010, 30(6): 1110-1120.

DOI：10.1038/jcbfm.2009.264

• aneurysm
• apparent diffusion coefficient
• diffusion
• magnetic resonance imaging
• outcome
• subarachnoid hemorrhage

We investigated the role of acute-stage diffusion-weighted images (DWIs) for predicting outcome of poor-grade subarachnoid hemorrhage (SAH). This study included 38 patients with poor-grade SAH who underwent DWI within 24 h after onset. DWI findings were divided into three groups on the basis of lesion area: none (N), spotty (S, <= 10 mm(2)), or areal (A, > 10 mm(2)). We evaluated the correlation between preoperative DWI findings and clinical outcome, and the characteristics of DWI abnormalities. DWI abnormalities were revealed in 81.6% of cases (group S 34.2%; group A 47.3%). All patients in groups N and S and 73.3% of patients in group A were treated radically. For those patients without rerupture, favorable outcomes were achieved in 100% of group N, 53.8% of group S, and 0% of group A. Abnormal lesions on initial DWI, which resulted in permanent lesions, showed a mean apparent diffusion coefficient ratio to the control value of 0.71, which was significantly lower than 0.95 observed in reversible lesions (P< 0.01). We recommend radical treatment for even poor-grade SAH as long as the preoperative DWI shows no or only spotty lesions. DWI may provide an objective means to estimate the outcome of poor-grade SAH. Journal of Cerebral Blood Flow & Metabolism (2010) 30, 1110-1120; doi: 10.1038/jcbfm.2009.264; published online 6 January 2010

• 出版日期2010-6