title: Functional diffusion map as an imaging predictor of functional outcome in patients with primary intracerebral haemorrhage.
abstract: OBJECTIVE
  Predicting outcome in patients with primary intracerebral haemorrhage (ICH) in the acute stage can provide information to determine the best therapeutic and rehabilitation strategies. We prospectively investigated the predictive value of the functional diffusion map (fDM) in the acute stage of ICH.
  
  
  METHODS
  47 patients with ICH were enrolled for clinical evaluation and MRI within 24 h of symptom onset and 5 days after ICH. Functional diffusion mapping prospectively monitored the apparent diffusion coefficient (ADC) maps of perihaematomal oedema. Consequently, the change in perihaematomal oedema was classified into three categories: increased, decreased, or no significant change. Clinical outcomes were evaluated 6 months after ICH according to the modified Rankin Scale. Correlation between clinical outcome and the fDMs was performed.
  
  
  RESULTS
  Among the clinical variables, thalamic haematoma, serum glucose level and National Institutes of Health Stroke Scale scores were significantly different between the good- and poor-outcome groups. The percentage of oedematous tissue undergoing significant change between baseline and Day 5 was also significantly different between the groups.
  
  
  CONCLUSIONS
  fDMs allow for spatial voxel-by-voxel tracking of changes in ADC values. It may be feasible to use fDMs to predict the functional outcome of patients with ICH during the acute stage. Advances in knowledge The use of fDMs for stroke study is demonstrated. fDMs may be more suitable to reflect the pathophysiological heterogeneity within oedemas and may facilitate another thinking process for imaging study of stroke and other neurological diseases.
authors.affiliation: Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Y-H
authors.initials: YH
authors.lastname: Tsai
authors.forename: L-M
authors.initials: LM
authors.lastname: Hsu
authors.forename: H-H
authors.initials: HH
authors.lastname: Weng
authors.forename: M-H
authors.initials: MH
authors.lastname: Lee
authors.forename: J-T
authors.initials: JT
authors.lastname: Yang
authors.forename: C-P
authors.initials: CP
authors.lastname: Lin
mesh_terms: D000368:Aged; D000465:Algorithms; D001929:Brain Edema / Q000175:diagnosis* / Q000209:etiology*; D001931:Brain Mapping / Q000379:methods*; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000175:diagnosis*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D020127:Recovery of Function; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity