Prognostic value of early phase proton magnetic resonance spectroscopy (1H-MRS) and diffusion tensor imaging (DTI) in comatose survivors of out-of-hospital cardiac arrest (OHCA) – A Substudy of the Xe-Hypotheca Trial

Congress:

ECR 2019

Poster Number:

C-1064

Type:

Scientific Exhibit

Keywords:

Neuroradiology brain, MR-Spectroscopy, MR-Diffusion/Perfusion, Outcomes analysis, Ischaemia / Infarction, Outcomes

Authors:

K. Koskensalo¹, S. M. M. Virtanen², J. Saunavaara¹, R. Parkkola¹, T. Laitio¹; ¹Turku/FI, ²Piikkiö/FI

DOI:

10.26044/ecr2019/C-1064

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-1064

Results

Patients

Of the randomised patients 93 had both DTI and 1H-MRS data available. The brain imaging was performed in a median (inter-quartile range) time of 53 hours (47-64) after OHCA. During the follow-up of six-months 27 patients (28%) died.

DTI and 1H-MRS results

Global fractional anisotropy values of the DTI, and tNAA/tCr and tNAA/tCho ratios of the 1H-MRS were significantly higher in the survivors and in patients with good neurological outcome than in the non-survivors and in patients with poor neurological outcome. Other DTI and 1H-MRS measures did not differ between the groups (Table 1). Results of the tract-based spatial statistics analysis are visualized with a statistical parametric map (Fig. 2).

Receiver operating characteristic analysis

The area under ROC curve (Fig. 3) was 0.73 (95% CI 0.61-0.85; P=0.0005) for global white matter fractional anisotropy, 0.76 (95% CI 0.65-0.87; P=0.0001) for ratio of total N-acetylaspartate over total creatine (tNAA/tCr) in basal ganglia, and for a combination of fractional anisotropy and tNAA/tCr 0.84 (0.76-0.93; P < 0.0001). There was no significant difference (P=0.77) in predictive power between fractional anisotropy and 1H-MRS.