Department of Emergency Medicine, Chonnam National University Hospital, 42 Jebong-ro, Donggu, Gwangju, 61469, Republic of Korea.
Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.
Neurocrit Care. 2024 Apr;40(2):538-550. doi: 10.1007/s12028-023-01776-4. Epub 2023 Jun 23.
Early identification of the severity of hypoxic-ischemic brain injury (HIBI) after cardiac arrest can be used to help plan appropriate subsequent therapy. We evaluated whether conductivity of cerebral tissue measured using magnetic resonance-based conductivity imaging (MRCI), which provides contrast derived from the concentration and mobility of ions within the imaged tissue, can reflect the severity of HIBI in the early hours after cardiac arrest.
Fourteen minipigs were resuscitated after 5 min or 12 min of untreated cardiac arrest. MRCI was performed at baseline and at 1 h and 3.5 h after return of spontaneous circulation (ROSC).
In both groups, the conductivity of cerebral tissue significantly increased at 1 h after ROSC compared with that at baseline (P = 0.031 and 0.016 in the 5-min and 12-min groups, respectively). The increase was greater in the 12-min group, resulting in significantly higher conductivity values in the 12-min group (P = 0.030). At 3.5 h after ROSC, the conductivity of cerebral tissue in the 12-min group remained increased (P = 0.022), whereas that in the 5-min group returned to its baseline level.
The conductivity of cerebral tissue was increased in the first hours after ROSC, and the increase was more prominent and lasted longer in the 12-min group than in the 5-min group. Our findings suggest the promising potential of MRCI as a tool to estimate the severity of HIBI in the early hours after cardiac arrest.
在心脏骤停后早期识别缺氧缺血性脑损伤(HIBI)的严重程度可用于帮助制定适当的后续治疗计划。我们评估了使用基于磁共振的电导率成像(MRCI)测量的脑组织电导率是否可以反映心脏骤停后早期 HIBI 的严重程度,MRCI 提供了来自成像组织内离子浓度和迁移率的对比度。
14 头小型猪在未治疗的心脏骤停 5 分钟或 12 分钟后进行复苏。在自主循环恢复(ROSC)后基线时和 1 小时及 3.5 小时进行 MRCI。
在两组中,与基线相比,ROSC 后 1 小时脑组织电导率均显著增加(5 分钟组和 12 分钟组分别为 P = 0.031 和 0.016)。12 分钟组的增加更大,导致 12 分钟组的电导率值显著升高(P = 0.030)。ROSC 后 3.5 小时,12 分钟组的脑组织电导率仍升高(P = 0.022),而 5 分钟组则恢复到基线水平。
ROSC 后最初几小时内脑组织电导率增加,12 分钟组的增加更明显且持续时间更长。我们的研究结果表明,MRCI 作为一种在心脏骤停后早期估计 HIBI 严重程度的工具具有很大的潜力。