Study on MRI Findings in Postresuscitation Brains.
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Purpose: We evaluated chronological changes in T1/T2-weighted and diffusion-weighted magnetic resonance imaging (MRI) findings in patients with global cerebral ischemia compared to computed tomography (CT) and single photon emission computed tomography (SPECT) to determine the advantages this presents in determining a patient's prognosis. Methods: We retrospectively studied MRI in 28 patients resuscitated after cardiopulmonary arrest. Patients were divided by outcome into 4 groups -- good outcome in 5, moderate disability in 2, vegetative in 17, and 4 brain-dead. Results: Those with good recovery had normal CT and MRI findings. Those with moderate disability demonstrated high signal intensity in basal ganglia and posterior cerebral cortex during the chronic period. All vegetative patients had abnormal CT findings and their T2-weighted images during the acute period demonstrated high signal intensity in the cerebral cortex and basal ganglia; T1-weighted image during the chronic period showed similar findings, while diffusion-weighted images indicated high signal intensity in the cerebral cortex from the very acute period, during which abnormal findings were seen in the cortex, putamen, and thalamus more frequently than in T2-weighted images. Moreover, regional cerebral blood flow significantly decreased during the chronic period. All brain-dead patients had CT findings of diffuse cerebral edema and loss of density difference between gray and white matter. T2-weighted images respectively showed an extraordinary high density difference between gray and white matter and diffusion-weighted images high signal density in the whole brain. Conclusion: MRI detects chronologic changes in postresuscitation brain damage better than CT findings. Diffusion-weighted images identify hypoxic-ischemic lesions during the very acute period. MRI thus appears useful in evaluating patient prognosis and care.
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
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