Prediction of motor function outcome after intracerebral hemorrhage using fractional anisotropy calculated from diffusion tensor imaging.
BACKGROUND
The efficacy of surgical evacuation in patients with intracerebral hemorrhage (ICH) remains unclear for recovery of motor function. The relationship between improvement of motor function outcome and sequential change of fractional anisotropy (FA) values was investigated in patients with ICH, to explore whether motor function outcome can be predicted in the early phase. Indication of the surgical hematoma evacuation was also considered.


METHODS
This prospective study included 23 patients with ICH. All patients underwent diffusion tensor imaging to measure the FA value five times: within 3 days, day 14, day 30, day 60, and day 90 after the onset. The regions of interest were determined on the b = 0 step of the echo planar imaging scans in the bilateral cerebral peduncles and were automatically transferred onto the FA images. The FA value was then calculated for each patient. Patients were divided into good and poor recovery groups according to the motor function outcome on day 90.


RESULTS
The mean FA value of the poor recovery group gradually decreased until day 90, but remained unchanged in the good recovery group. The mean FA value on day 3 was significantly higher (p < 0.001) in the good recovery group (0.745 ± 0.0073) than in the poor recovery group (0.682 ± 0.0090). Receiver operating characteristic curve analysis showed that the FA value on day 3 could predict motor function outcome with a sensitivity of 100% and a specificity of 77.8% at an FA value of 0.7 on day 3.


CONCLUSIONS
The main finding of this study was that the FA values of the cerebral peduncle on the pathological side in patients with ICH on day 3 could predict the motor function outcome on day 90.
Department of Neurosurgery, Iwate Medical University, Morioka, Japan.
Yasutaka
Y
Kuzu
Takashi
T
Inoue
Yoshiyuki
Y
Kanbara
Hideaki
H
Nishimoto
Shunro
S
Fujiwara
Kuniaki
K
Ogasawara
Akira
A
Ogawa
D000368:Aged; D000369:Aged, 80 and over; D016880:Anisotropy; D002543:Cerebral Hemorrhage / Q000473:pathology* / Q000503:physiopathology*; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011712:Pyramidal Tracts / Q000473:pathology / Q000503:physiopathology; D020127:Recovery of Function / Q000502:physiology*; D013681:Tegmentum Mesencephali / Q000473:pathology / Q000503:physiopathology; D013997:Time Factors