Can Apparent Diffusion Coefficient Predict the Clinical Outcome in Drowned Children?
BACKGROUND
Pediatric cerebral hypoxic-ischemic injury frequently results in severe neurological outcome. Imaging with diffusion-weighted magnetic resonance imaging (DWi) demonstrates that the acute cerebral injury and apparent diffusion coefficient (ADC) allow the assessment of the severity of brain damage. The main objective was to examine if spatial distribution of reductions in ADC values is associated with clinical outcome in drowned children.


METHODS
This is a retrospective study of 7 children (7 examinations) suffering from a hypoxic-ischemic event who underwent DWi. Seven subjects with normal DWi served as controls. The mean patient age was 4.88 ± 2.93 years and the male-to-female ratio was 5:2. The neurological outcome was divided into 2 categories: 4 children with Apallic syndrome and 3 deaths. We analysed the differences between the drowned children and the control group regarding clinical data, DWi abnormalities, and ADC values.


RESULTS
The ADC values in the occipital and parietal grey matter were significantly different between the drowned children (765.14 ± 65.47 vs 920.95 ± 69.62; P = .003) and the control group (670.82 ± 233.99 vs 900.66 ± 92.72; P = .005). The ADC showed low values in the precentral area also (P = .044).


CONCLUSIONS
The ADC reduction may be useful to predict the poor outcome in drowned children and can be a valuable tool for clinical assessment.
Division of Medical Biophysics, University of Medicine & Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania.
Adrian
A
Hruşcã
Division of Pediatrics II, University of Medicine & Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania. Electronic address: rachisan_andreea@yahoo.com.
Andreea Liana
AL
Rãchişan
Department of Pediatrics, Medical University of Graz, Graz, Austria.
Siegfried
S
Rödl
Division of Pediatric Radiology, Department of Radiology, Medical University of Graz, Graz, Austria.
Erich
E
Sorantin
D002675:Child, Preschool; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D015701:Near Drowning / Q000150:complications / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies
Apparent diffusion coefficient; Cerebral; Diffusion-weighted imaging; Drowning