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http://hdl.handle.net/10609/147008
Títol: | Acute corticospinal tract diffusion tensor imaging predicts 6-month functional outcome after intracerebral haemorrhage |
Autoria: | Schwarz, G. Kanber, Baris Prados Carrasco, Ferran Browning, S. Simister, R. Jäger, Hans Rolf Ambler, G. Gandini Wheeler-Kingshott, Claudia A.M. Werring, David |
Altres: | University College London (UCL) Universitat Oberta de Catalunya (UOC) |
Citació: | Schwarz, G., Kanber, B., Prados, F., Browning, S., Simister, R., Jäger, H.R., Ambler, G., Wheeler-Kingshott, C. & Werring, D. (2022). Acute corticospinal tract diffusion tensor imaging predicts 6-month functional outcome after intracerebral haemorrhage. Journal of Neurology, 1-9. doi: 10.1007/s00415-022-11245-1 |
Resum: | Introduction: Diffusion tensor imaging (DTI) can assess the structural integrity of the corticospinal tract (CST) in vivo. We aimed to investigate whether CST DTI metrics after intracerebral haemorrhage (ICH) are associated with 6-month functional outcome and can improve the predictive performance of the existing ICH score. Methods: We retrospectively included 42 patients with DTI performed within 5 days after deep supratentorial spontaneous ICH. Ipsilesional-to-contralesional ratios were calculated for fractional anisotropy (rFA) and mean diffusivity (rMD) in the pontine segment (PS) of the CST. We determined the most predictive variables for poor 6-month functional outcome [modified Rankin Scale (mRS) > 2] using the least absolute shrinkage and selection operator (LASSO) method. We calculated discrimination using optimism-adjusted estimation of the area under the curve (AUC). Results: Patients with 6-month mRS > 2 had lower rFA (0.945 [± 0.139] vs 1.045 [± 0.130]; OR 0.004 [95% CI 0.00–0.77]; p = 0.04) and higher rMD (1.233 [± 0.418] vs 0.963 [± 0.211]; OR 22.5 [95% CI 1.46–519.68]; p = 0.02). Discrimination (AUC) values were: 0.76 (95% CI 0.61–0.91) for the ICH score, 0.71 (95% CI 0.54–0.89) for rFA, and 0.72 (95% CI 0.61–0.91) for rMD. Combined models with DTI and non-DTI variables offer an improvement in discrimination: for the best model, the AUC was 0.82 ([95% CI 0.68–0.95]; p = 0.15). Conclusion: In our exploratory study, PS-CST rFA and rMD had comparable predictive ability to the ICH score for 6-month functional outcome. Adding DTI metrics to clinical-radiological scores might improve discrimination, but this needs to be investigated in larger studies. |
Paraules clau: | deep intracerebral haemorrhage outcome prediction ractional anisotropy mean diffusiviy ICH score corticospinal tract hemorragia intracerebral profunda predicción de resultados anisotropía fraccionada difusión media puntaje ICH tracto corticoespinal |
DOI: | https://doi.org/10.1007/s00415-022-11245-1 |
Tipus de document: | info:eu-repo/semantics/article |
Versió del document: | info:eu-repo/semantics/publishedVersion |
Data de publicació: | 21-jul-2022 |
Llicència de publicació: | https://creativecommons.org/licenses/by/4.0/ |
Apareix a les col·leccions: | Articles cientÍfics Articles |
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Acute corticospinal tract diffusion tensor imaging predicts 6-month functional outcome after intracerebral haemorrhage.pdf | 906,87 kB | Adobe PDF | Veure/Obrir |
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