title: Global and Regional Derangements of Cerebral Blood Flow and Diffusion Magnetic Resonance Imaging after Pediatric Cardiac Arrest.
abstract: OBJECTIVE
  To quantify and examine the relationship between global and regional cerebral blood flow (CBF) and water diffusion on brain magnetic resonance imaging (MRI) in children after cardiac arrest.
  
  
  METHODS
  Children admitted to a tertiary care children's hospital from July 2011 to April 2013 who received a brain MRI within 2 weeks after cardiac arrest that included arterial spin labeling and apparent diffusion coefficient (ADC) sequences were studied. CBF and ADC values were calculated globally and in 19 regions of interest. Outcome variables included survival and favorable neurologic outcome, which was defined as Pediatric Cerebral Performance Category ≤3 at 6 months. We examined global and regional relationships between CBF and ADC and their association with outcome.
  
  
  RESULTS
  This sample included 14 pediatric patients (mean time to MRI 6 ± 4 days), 9 of whom survived and 6 who survived with favorable outcome. Global ADC was significantly decreased in patients with unfavorable outcome (P = .02). Increased CBF and decreased ADC often were colocalized in the same region, especially in children who had unfavorable outcomes.
  
  
  CONCLUSIONS
  In this exploratory study, global restricted water diffusion on ADC after pediatric cardiac arrest was associated with unfavorable outcome. MRI assessments of perfusion and diffusion may have prognostic value after pediatric cardiac arrest.
authors.affiliation: University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Leah C
authors.initials: LC
authors.lastname: Manchester
authors.affiliation: Department of Radiology, Children's Hospital of Pittsburgh, Pittsburgh, PA.
authors.forename: Vince
authors.initials: V
authors.lastname: Lee
authors.affiliation: Department of Radiology, Children's Hospital of Pittsburgh, Pittsburgh, PA.
authors.forename: Vincent
authors.initials: V
authors.lastname: Schmithorst
authors.affiliation: Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA; Safar Center for Resuscitation Research, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Kochanek
authors.affiliation: Department of Radiology, Children's Hospital of Pittsburgh, Pittsburgh, PA.
authors.forename: Ashok
authors.initials: A
authors.lastname: Panigrahy
authors.affiliation: Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA; Safar Center for Resuscitation Research, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA. Electronic address: FinkEL@ccm.upmc.edu.
authors.forename: Ericka L
authors.initials: EL
authors.lastname: Fink
mesh_terms: D000293:Adolescent; D002560:Cerebrovascular Circulation; D002648:Child; D002675:Child, Preschool; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006323:Heart Arrest / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male