|
KMID : 1001920180610010097
|
|
Journal of Korean Neurosurgical Society
2018 Volume.61 No. 1 p.97 ~ p.104
|
|
|
The Potential of Diffusion-Weighted Magnetic Resonance Imaging for Predicting the Outcomes of Chronic Subdural Hematomas
|
|
Lee Seung-Hwan
Choi Jong-Il
Lim Dong-Jun
Ha Sung-Kon
Kim Sang-Dae
Kim Se-Hoon
|
|
|
Abstract
|
|
|
Objective: Diffusion-weighted magnetic resonance imaging (DW-MRI) has proven useful in the study of the natural history of ischemic stroke. However, the potential of DW-MRI for the evaluation of chronic subdural hematoma (CSDH) has not been established. In this study, we investigated DW-MRI findings of CSDH and evaluated the impact of the image findings on postoperative outcomes of CSDH.
Methods: We studied 131 CSDH patients who had undergone single burr hole drainage surgery. The images of the subdural hematomas on preoperative DW-MRI and computed tomography (CT) were divided into three groups based on their signal intensity and density: 1) homogeneous (iso or low) density on CT and homogeneous low signal intensity on DW-MRI; 2) homogeneous (iso or low) density on CT and mixed signal intensity on DW-MRI; and 3) heterogeneous density on CT and mixed signal intensity on DW-MRI. On the basis of postoperative CT, we also divided the patients into 3 groups of surgical outcomes according to residual hematoma and mass effect.
Results: Analysis showed statistically significant differences in surgical (A to B: p<0.001, A to C: p<0.001, B to C: p=0.129) and functional (A to B: p=0.039, A to C: p<0.001, B to C: p=0.108) outcomes and treatment failure rates (A to B: p=0.037, A to C: p=0.03, B to C: p=1) between the study groups. In particular, group B and group C showed worse outcomes and higher treatment failure rates than group A.
Conclusion: CSDH with homogeneous density on CT was characterized by signal intensity on DW-MRI. In CSDH patients, performing DW-MRI as well as CT helps to predict postoperative treatment failure or complications.
|
|
|
KEYWORD
|
|
|
Hematoma, Subdural, Chronic , Diffusion magnetic resonance imaging
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
   
|
|