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J Korean Soc Emerg Med > Volume 28(5); 2017 > Article
Journal of The Korean Society of Emergency Medicine 2017;28(5): 441-448.
심정지 환자의 예후 평가에서 자화율강조자기공명영상 소견의 유용성: 선행연구
황진태1, 김용환1*, 이준호1, 조광원1, 강문주1, 이동우1, 송윤규2, 김정민3, 변정훈4, 황성연1, 이정화5
1성균관대학교 의과대학 삼성창원병원 응급의학과
2성균관대학교 의과대학 삼성창원병원 영상의학과
3창신대학교 간호학과
4창원경상대학교병원 흉부외과
5성균관대학교 의과대학 삼성창원병원 신경과
Utility of Susceptibility-Weighted Imaging in Comatose Patients after Cardiac Arrest: A Preliminary Study
Jin Tae Hwang1, Yong Hwan Kim1*, Jun Ho Lee1, Kwang Won Cho1, Mun Ju Kang1, Dong Woo Lee1, Yun Gyu Song2, Jung Min Kim3, Joung Hun Byun4, Seong Youn Hwang1, Jung Hwa Lee5
1Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
2Department of Radiology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
3Department of Nursing, Changshin University, Changwon, Korea
4Department of Thoracic and Cardiovascular Surgery, Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
5Department of Neurology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
Correspondence  Yong Hwan Kim ,Tel: 055-290-6657, Fax: 055-290-6117, Email: suka1212@naver.com,
Received: May 10, 2017; Revised: May 16, 2017   Accepted: August 25, 2017.  Published online: October 31, 2017.
ABSTRACT
Purpose:
This study was conducted to examine the efficacies of susceptibility weighted images (SWI) for predicting the clinical prognosis of comatose patients following cardiac arrest.
Method:
Thirty-two patients who were resuscitated from cardiac arrest and underwent brain magnetic resonance imaging (MRI) were retrospectively investigated and compared to 32 subjects with normal brain MRI findings who served as controls. The SWI readings were divided into three categories: prominent, diminished, and normal. Comatose patients were divided into two groups: those with a Glasgow-Pittsburgh cerebral performance category (CPC) of 1-2 (good outcome group) and those with a CPC of 3-5 (poor outcome group).
Results:
Of the 32 patients, 17 (53.1%) showed good neurological outcomes upon hospital discharge. Normal patterns on SWI were mainly seen in the good outcome group (15 patients, 88.2%), while diminished patterns and prominent patterns were frequently found in the poor outcome group (13 patients, 88.7%). The combination of diminished pattern and prominent pattern predicted poor outcome with 86.7% sensitivity (95% confidence interval, 69.5%-100%) and 88.2% specificity (95% confidence interval, 72.9%-100%).
Conclusion:
The SWI findings correlate with the outcome of hypoxic-ischemic encephalopathy and may be a useful adjunct of vegetative state or death in comatose patients after cardiac arrest.
Key words: Hypoxic-ischemic encephalopathies, Cardiac arrest, Magnetic resonance imaging
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