Wani Abrar Ahad, Phadke Rv, Behari Sanjay, Sahu Rn, Jaiswal Awdesh, Jain Vk
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Neurosurgery, UP, India.
Turk Neurosurg. 2008 Jan;18(1):10-6.
Efficacy of DWI in detecting ischemic injury following anterior communicating artery aneurysmal SAH is studied
In this prospective study ,16 patients within 5 days of their ictus were included. Preoperative CT scan excluded an intracerebral infarct; an angiogram determined the extent of vasospasm; MR studies were done to detect cerebral ischemia and the diffusion coefficient (ADC) was calculated. Patients underwent surgery (n=12) or endovascular coiling (n=4). Postintervention CT scan within 24 hours and on day 5 determined radiological outcome as good or poor depending on the absence or presence of infarction. Clinical outcome at follow up (2-6 months) was regarded as good or poor when the patient was independent or dependent regarding daily activities, respectively,.
Restricted diffusion occurred in 8 (80%) of poor and in 1 (16.6%) of good grade patients (p < 0.05). In patients with good radiological outcome (n=8), DWI restriction occurred in 2 (25%) patients. In patients with poor radiological outcome(n=8), DWI restriction occurred in 7 (87.5%) patients . At 2-6 month follow-up, 7 (77.8%) of 9 patients with restricted diffusion and 2 of 7 patients with no DWI abnormality showed a poor clinical outcome
Clinical and radiological outcome at follow-up is related to the preoperative DWI.
研究弥散加权成像（DWI）在检测前交通动脉瘤性蛛网膜下腔出血（SAH）后缺血性损伤中的效能。
在这项前瞻性研究中，纳入了16例发病5天内的患者。术前CT扫描排除脑内梗死；血管造影确定血管痉挛程度；进行磁共振成像（MR）研究以检测脑缺血并计算扩散系数（ADC）。患者接受手术（n = 12）或血管内栓塞治疗（n = 4）。干预后24小时内及第5天的CT扫描根据有无梗死确定影像学结果为良好或不佳。随访（2 - 6个月）时的临床结果，当患者在日常活动中独立或依赖时，分别视为良好或不佳。
在预后不良的患者中，8例（80%）出现扩散受限，而预后良好的患者中1例（16.6%）出现扩散受限（p < 0.05）。在影像学结果良好的患者（n = 8）中，2例（25%）出现DWI受限。在影像学结果不佳的患者（n = 8）中，7例（87.5%）出现DWI受限。在2 - 6个月的随访中，9例扩散受限患者中的7例（77.8%）以及7例DWI无异常患者中的2例临床预后不佳。
随访时的临床和影像学结果与术前DWI相关。
