title: Early diffusion-weighted magnetic resonance imaging in children after cardiac arrest may provide valuable prognostic information on clinical outcome.
abstract: OBJECTIVE
  We examined whether early diffusion-weighted magnetic resonance imaging (DW-MRI) abnormalities of the brain and variation of apparent diffusion coefficient (ADC) values can provide prognostic information on clinical outcome in children following cardiac arrest (CA).
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  A 12-bed paediatric intensive care unit (PICU).
  
  
  METHODS
  Children aged between 1 month and 18 years who had DW-MRI with ADC measurement within the first week following CA. Neurological outcomes were assessed using the Pediatric Cerebral Performance Category Scale (PCPC). Differences between the favourable (PCPC ≤3) and unfavourable (PCPC ≥4) groups were analysed with regard to clinical data, electrophysiological patterns as well as qualitative and quantitative DW-MRI abnormalities.
  
  
  RESULTS
  Twenty children with a median age of 20 months (1.5-185) and a male/female sex ratio of 1.5 underwent DW-MRI after CA with a median delay of 3 days (1-7). Aetiologies of CA were (i) asphyxia (n = 10), (ii) haemodynamic (n = 5) or (iii) unknown (n = 5). With regard to DW-MRI findings, the unfavourable outcome group (n = 8) was associated with cerebral cortex (p = 0.02) and basal ganglia (p = 0.005) lesions, with a larger number of injured brain regions (p = 0.001) and a global decrease in measured ADC signal (p = 0.008). Normal DW-MRI (n = 5) was exclusively associated with the favourable outcome group (n = 12).
  
  
  CONCLUSIONS
  Qualitative, topographic and quantitative analysis of early DW-MRI with ADC measurement in children following CA may provide valuable prognostic information on neurological outcomes.
authors: Service de Réanimation Pédiatrique, Hôpital Necker Enfants-Malades, Assistance Publique, Hôpitaux de Paris, Faculté de Médecine, Université Paris-Descartes, 149, Rue de Sèvres, 75743, Paris Cedex 15, France. mehdi.oualha@nck.aphp.fr
authors: Mehdi
authors: M
authors: Oualha
authors: Pauline
authors: P
authors: Gatterre
authors: Nathalie
authors: N
authors: Boddaert
authors: Laurent
authors: L
authors: Dupic
authors: Laure
authors: L
authors: De Saint Blanquat
authors: Philippe
authors: P
authors: Hubert
authors: Fabrice
authors: F
authors: Lesage
authors: Isabelle
authors: I
authors: Desguerre
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D038524:Diffusion Magnetic Resonance Imaging; D042241:Early Diagnosis; D004569:Electroencephalography; D005260:Female; D006323:Heart Arrest / Q000150:complications*; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000473:pathology*; D007223:Infant; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies
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