title: A comparative study of fractional anisotropy measures and ICH score in predicting functional outcomes after intracerebral hemorrhage.
abstract: BACKGROUND
  Improved prognostication during the acute phase of intracerebral hemorrhage (ICH) could influence goals of care. We investigated the utility of diffusion tensor imaging (DTI)-derived data obtained during the acute phase of ICH in predicting outcome, compared with the ICH score.
  
  
  METHODS
  We measured fractional anisotropy (FA) values in 5 slices below the level of the lesion on the affected and unaffected corticospinal tracts (CST) and in the cerebral peduncles (CPs) in 32 patients with supratentorial ICH who had DTI MRI within 4 days after ictus. We calculated the FA ratio (rFA = FAaffected side/FAunaffected side), and examined the value of the ICH score and rFA in predicting functional outcome assessed by modified Ranking Scale (mRS) at follow-up, using ROC analyses.
  
  
  RESULTS
  The rFA values at the CPs level, but not the 5 slices below the lesion, were significantly lower in the group with poor functional outcome (defined as mRS > 2) than in those with good functional outcome (0.96 ± 0.14 vs. 0.99 ± 0.08, p = 0.025). The ICH score had greater areas under ROC curve in predicting functional outcome compared to the mean rFA (AUC 0.74 vs. 0.44; p = 0.01 for mRS > 2; and 0.84 vs. 0.40; p < 0.001 for mRS > 3).
  
  
  CONCLUSIONS
  The prognostic value of the ICH score surpassed that of DTI-derived data during the acute phase of ICH in this cohort of patients. Prospective and larger studies are needed to validate our findings and to assess the prognostic role of various DTI-derived measures at different times following ICH.
authors: Stroke Division, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Palmer 127, Boston, MA, 02115, USA.
authors: Wen-Dan
authors: WD
authors: Tao
authors: Jasmine
authors: J
authors: Wang
authors: Gottfried
authors: G
authors: Schlaug
authors: Ming
authors: M
authors: Liu
authors: Magdy H
authors: MH
authors: Selim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016880:Anisotropy; D001921:Brain / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000473:pathology; D065850:Cerebral Peduncle / Q000473:pathology*; D015331:Cohort Studies; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011712:Pyramidal Tracts / Q000473:pathology*; D020127:Recovery of Function; D012189:Retrospective Studies