Added Value of Quantitative Apparent Diffusion Coefficient Values for Neuroprognostication After Cardiac Arrest
| Autor: | Bert Ferdinande, Lauranne Scheldeman, Anke Wouters, Ronald Peeters, Stefan Janssens, Sarah Cappelle, Philippe Demaerel, Wim Van Paesschen, Matthias Dupont, Jo Dens, Koen Ameloot, Robin Lemmens, Sam Plessers |
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| Přispěvatelé: | Neurology |
| Rok vydání: | 2020 |
| Předmět: |
Male
Electroencephalography computer.software_genre law.invention 03 medical and health sciences 0302 clinical medicine Text mining Randomized controlled trial Voxel law medicine Effective diffusion coefficient Humans Corneal reflex Aged medicine.diagnostic_test Receiver operating characteristic business.industry 030208 emergency & critical care medicine Recovery of Function Middle Aged Prognosis Heart Arrest Diffusion Magnetic Resonance Imaging Somatosensory evoked potential Hypoxia-Ischemia Brain Female Neurology (clinical) Nuclear medicine business computer 030217 neurology & neurosurgery |
| Zdroj: | Neurology, 96(21), e2611-e2618. Lippincott Williams and Wilkins |
| ISSN: | 1526-632X 0028-3878 |
| Popis: | ObjectiveTo test the prognostic value of brain MRI in addition to clinical and electrophysiologic variables in patients post–cardiac arrest (CA), we explored data from the randomized Neuroprotect Post-CA trial (NCT02541591).MethodsIn this trial, brain MRIs were prospectively obtained. We calculated receiver operating characteristic (ROC) curves for the average apparent diffusion coefficient (ADC) value and percentage of brain voxels with an ADC value −6 mm2/s and −6 mm2/s. We constructed multivariable logistic regression models with clinical characteristics, EEG, somatosensory evoked potentials (SSEP), and ADC value as independent variables to predict good neurologic recovery.ResultsIn 79/102 patients, MRI data were available and in 58/79 patients all other data were available. At 180 days post-CA, 25/58 (43%) patients had good neurologic recovery. In univariable analysis of all tested MRI measures, average ADC value in the postcentral cortex had the highest accuracy to predict good neurologic recovery, with an area under the ROC curve (AUC) of 0.78. In the most optimal multivariable model, which also included corneal reflexes and EEG, this measure remained an independent predictor of good neurologic recovery (AUC 0.96, false-positive 27%). This model provided a more accurate prediction compared to the most optimal combination of EEG, corneal reflexes, and SSEP (p = 0.03).ConclusionsAdding information on brain MRI in a multivariable model may improve the prediction of good neurologic recovery in patients post-CA.Classification of EvidenceThis study provides Class III evidence that MRI ADC features predict neurologic recovery in patients post-CA. |
| Databáze: | OpenAIRE |
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