Fragata Isabel, Canhão Patrícia, Alves Marta, Papoila Ana Luísa, Canto-Moreira Nuno
Serviço de Neurorradiologia, Centro Hospitalar Lisboa Central, Hospital São José, Rua José António Serrano, Lisbon, 1150-045, Portugal.
NOVA Medical School, Lisbon, Portugal.
Neuroradiology. 2017 Jan;59(1):13-21. doi: 10.1007/s00234-016-1774-y. Epub 2016 Dec 27.
Few studies assessed diffusion tensor imaging (DTI) changes in the acute phase of subarachnoid haemorrhage (SAH). We prospectively evaluated DTI parameters in the acute phase of SAH and 8-10 days after and analysed whether changes could be related to SAH severity or to the development of delayed cerebral ischemia (DCI).
Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) changes over time were assessed in a prospective cohort of patients with acute SAH. Two MRI studies were performed at <72 h (MRI-1) and 8-10 days (MRI-2). DTI parameters were recorded in 15 ROIs. Linear mixed regression models were used.
Forty-two patients were included. Subtle changes in DTI parameters were found between MRI-1 and MRI-2. At the posterior limb of internal capsule (PLIC), a weak evidence of a 0.02 mean increase in FA (p = 0.064) and a 17.55 × 10 mm/s decrease in ADC (p = 0.052) were found in MRI-2. Both FA and ADC changed over time at the cerebellum (increase of 0.03; p = 0.017; decrease of 34.73 × 10 mm/s; p = 0.002, respectively). Patients with DCI had lower FA values on MRI-1 and lower ADC on MRI-2, although not reaching statistical significance, compared to non-DCI patients. DTI parameters on MRI-1 were not correlated to clinical admission scales.
ADC and FA values show subtle changes over time in acute SAH at the PLIC and cerebellum although not statistically associated with the severity of SAH or the occurrence of DCI. However, DTI changes occurred mainly in DCI patients, suggesting a possible role of DTI as a marker of DCI.
很少有研究评估蛛网膜下腔出血（SAH）急性期的扩散张量成像（DTI）变化。我们前瞻性地评估了SAH急性期及之后8 - 10天的DTI参数，并分析了这些变化是否与SAH严重程度或迟发性脑缺血（DCI）的发生有关。
在一个急性SAH患者的前瞻性队列中评估表观扩散系数（ADC）和分数各向异性（FA）随时间的变化。在<72小时（MRI - 1）和8 - 10天（MRI - 2）进行了两项MRI研究。在15个感兴趣区域记录DTI参数。使用线性混合回归模型。
纳入了42例患者。在MRI - 1和MRI - 2之间发现DTI参数有细微变化。在MRI - 2中，在内囊后肢（PLIC），发现FA平均增加0.02的证据较弱（p = 0.064），ADC降低17.55×10 mm/s（p = 0.052）。在小脑，FA和ADC均随时间变化（分别增加0.03；p = 0.017；降低34.73×10 mm/s；p = 0.002）。与非DCI患者相比，DCI患者在MRI - 1上的FA值较低，在MRI - 2上的ADC较低，尽管未达到统计学意义。MRI - 1上的DTI参数与临床入院量表无关。
在急性SAH中，PLIC和小脑的ADC和FA值随时间显示出细微变化，尽管与SAH严重程度或DCI的发生无统计学关联。然而，DTI变化主要发生在DCI患者中，提示DTI可能作为DCI的一个标志物。
