The value of susceptibility-weighted imaging (SWI) in patients with non-neonatal hypoxic-ischemic encephalopathy


Autoria(s): Wagner, Franca; Hänggi, Matthias; Wagner, Bendicht Peter; Weck, Anja; Weisstanner, Christian; Grunt, Sebastian; Z'Graggen, Werner Josef; Gralla, Jan; Wiest, Roland; Verma, Rajeev Kumar
Data(s)

07/01/2015

Resumo

OBJECTIVE In susceptibility-weighted imaging (SWI) in the normal brain, cortical veins appear hypointense due to paramagnetic properties of deoxy-hemoglobin. Global cerebral anoxia decreases cerebral oxygen metabolism, thereby increasing oxy-hemoglobin levels in cerebral veins. We hypothesized that a lower cerebral oxygen extraction fraction in comatose patients with non-neonatal hypoxic ischemic encephalopathy (IHE) produce a pattern of global rarefied or pseudo-diminished cortical veins due to higher oxy-hemoglobin. PURPOSE 1. To investigate the topographic relationship between susceptibility effects in cortical veins and related diffusion restrictions on diffusion-weighted imaging (DWI) in patients with IHE. 2. To relate imaging findings to patterns of altered resting activity on surface EEG. METHODS Twenty-three IHE patients underwent MRI. EEG patterns were used to classify the depth of coma. Regional vs. global susceptibility changes on SWI and patterns of DWI restrictions were compared with the depth of coma. RESULTS All patients exhibited areas of restricted cortical diffusion and SWI abnormalities. The dominant DWI restrictions encompassed widespread areas along the precuneus, frontal and parietal association cortices and basal ganglia. For SWI, nineteen patients had generalized bi-hemispherical patterns, the EEG patterns correlated with coma grades III to V. Four patients had focal decreases of deoxy-hemoglobin following DWI restrictions; associated with normal EEGs. CONCLUSION Focal patterns of diamagnetic effects on SWI according to relative decreases in deoxy-hemoglobin due to reduced metabolic demand are associated with normal EEG in IHE patients. Global patterns indicated increased depth of coma and widespread cortical damage. CLINICAL RELEVANCE The results indicate a potential diagnostic value of SWI in patients with IHE.

Formato

application/pdf

Identificador

http://boris.unibe.ch/61865/1/1-s2.0-S0300957215000064-main.pdf

Wagner, Franca; Hänggi, Matthias; Wagner, Bendicht Peter; Weck, Anja; Weisstanner, Christian; Grunt, Sebastian; Z'Graggen, Werner Josef; Gralla, Jan; Wiest, Roland; Verma, Rajeev Kumar (2015). The value of susceptibility-weighted imaging (SWI) in patients with non-neonatal hypoxic-ischemic encephalopathy. Resuscitation, 88, pp. 75-80. Elsevier Science Ireland 10.1016/j.resuscitation.2014.12.024 <http://dx.doi.org/10.1016/j.resuscitation.2014.12.024>

doi:10.7892/boris.61865

info:doi:10.1016/j.resuscitation.2014.12.024

info:pmid:25576980

urn:issn:0300-9572

Idioma(s)

eng

Publicador

Elsevier Science Ireland

Relação

http://boris.unibe.ch/61865/

Direitos

info:eu-repo/semantics/restrictedAccess

Fonte

Wagner, Franca; Hänggi, Matthias; Wagner, Bendicht Peter; Weck, Anja; Weisstanner, Christian; Grunt, Sebastian; Z'Graggen, Werner Josef; Gralla, Jan; Wiest, Roland; Verma, Rajeev Kumar (2015). The value of susceptibility-weighted imaging (SWI) in patients with non-neonatal hypoxic-ischemic encephalopathy. Resuscitation, 88, pp. 75-80. Elsevier Science Ireland 10.1016/j.resuscitation.2014.12.024 <http://dx.doi.org/10.1016/j.resuscitation.2014.12.024>

Palavras-Chave #610 Medicine & health
Tipo

info:eu-repo/semantics/article

info:eu-repo/semantics/publishedVersion

PeerReviewed