Medial Occipital Lobe Hyperperfusion Identified by Arterial Spin-Labeling: A Poor Prognostic Sign in Patients with Hypoxic-Ischemic Encephalopathy.
Hypoxic-ischemic encephalopathy carries an uncertain prognosis. We sought to retrospectively assess the prognostic value of arterial spin-labeling MR imaging in 22 adult patients diagnosed with hypoxic-ischemic encephalopathy. Quantitative CBF maps were generated from the M0 map, and arterial spin-labeling data on a per-voxel basis were regionally interrogated via visual inspection and ROI placement. Hyperperfusion was defined as regional increases in CBF of >20% (relative to global CBF) and/or >100 mL/100 g/min. Eleven of 22 patients had prominent bilateral medial occipital lobe hyperperfusion, all of whom died before hospital discharge. One patient who had nondistinct arterial spin-labeling hyperperfusion and restricted diffusion survived. Medial occipital lobe hyperperfusion is a distinctive pattern that merits prospective investigation in a cohort of patients with moderate hypoxic-ischemic encephalopathy to determine its predictive ability in patients with a higher likelihood of survival.
From the Department of Neurology (A.d.H., J.M.), University of Utah, Salt Lake City, Utah.
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de Havenon
Departments of Neurology (A.S.-Q., D.T.).
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Sultan-Qurraie
Departments of Neurology (A.S.-Q., D.T.).
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Tirschwell
Radiology (W.C., J.B.A.), University of Washington, Seattle, Washington.
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Cohen
From the Department of Neurology (A.d.H., J.M.), University of Utah, Salt Lake City, Utah.
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Majersik
Radiology (W.C., J.B.A.), University of Washington, Seattle, Washington. drjalal@uw.edu.
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Andre
D000328:Adult; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009778:Occipital Lobe / Q000098:blood supply*; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D013113:Spin Labels
D013113:Spin Labels