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J Korean Soc Emerg Med > Volume 35(2); 2024 > Article
Journal of The Korean Society of Emergency Medicine 2024;35(2): 95-100.
심정지 환자의 초기 brain CT에서 정량적인 posterior ambient cistern 크기의 측정
이창훈 , 이재훈
동아대학교 의과대학 응급의학교실
Quantitative size measurement of the posterior ambient cistern in early brain computed tomography of patients with cardiac arrest
Changhun Lee , Jae Hoon Lee
Department of Emergency Medicine, Dong-A University College of Medicine, Busan, Korea
Correspondence  Jae Hoon Lee ,Tel: 051-240-5590, Fax: 051-240-5309, Email: leetoloc@dau.ac.kr,
Received: June 17, 2023; Revised: September 22, 2023   Accepted: October 11, 2023.  Published online: April 30, 2024.
ABSTRACT
Objective:
Predictors for neuroprognostication in early brain computed tomography (CT) within 24 hours of cardiac arrest are available for patients, but have not been very promising. Quantitative cistern effacement has not been investigated, although the gray matter to white matter ratio (GWR) and optic nerve sheath diameter (ONSD)/eyeball transverse diameter (ETD) in early brain CT have been extensively studied. We aimed to determine the performance of quantitative cistern effacement compared to that of GWRs and ONSD/ETD for neuroprognostication.
Method:
This retrospective study was performed in a tertiary teaching hospital and included adult patients with cardiac arrest who underwent brain CT and targeted temperature management. GWRs, the distance of the posterior ambient cistern, and ONSD/ETD in early brain CT were measured.
Results:
Among the 75 patients included in the study, 36 patients showed poor neurological outcomes. The region of interest (ROI) in the putamen was significantly different in patients with a poor neurological outcome (P=0.031), but the ROI in the caudate nucleus was not (P=0.229). ONSD/ETD was not correlated with a poor neurological outcome. When compared with the GWR of the putamen/posterior internal capsule (odds ratio [OR], 0.619; P=0.063) and ONSD/ETD (OR, 1.774; P=0.457), the distance of the posterior ambient cistern correlated most with poor neurological outcomes (OR, 0.494; P=0.013,) and the area under receiver operating characteristic curve was 0.689.
Conclusion:
Quantitative cistern effacement in the early brain CT of cardiac arrest patients can assist neuroprognostication. Studies with larger sample sizes and follow-up of brain CT are warranted to confirm these results.
Key words: Out-of-hospital cardiac arrest; Multidetector computed tomography; Prognosis
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