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

Kenichi Sato, Hiroaki Shimizu, Miki Fujimura, Takashi Inoue, Yasushi Matsumoto, Teiji Tominaga

Research output: Contribution to journalArticlepeer-review

34 Citations (Scopus)

Abstract

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 (P0.01). 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.

Original languageEnglish
Pages (from-to)1110-1120
Number of pages11
JournalJournal of Cerebral Blood Flow and Metabolism
Volume30
Issue number6
DOIs
Publication statusPublished - 2010 Jun

Keywords

  • Aneurysm
  • Apparent diffusion coefficient
  • Diffusion
  • Magnetic resonance imaging
  • Outcome
  • Subarachnoid hemorrhage

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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