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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleAdult Brain
Open Access

Parieto-Occipital Injury on Diffusion MRI Correlates with Poor Neurologic Outcome following Cardiac Arrest

E. Calabrese, S. Gandhi, J. Shih, M. Otero, D. Randazzo, C. Hemphill, R. Huie, J.F. Talbott and E. Amorim
American Journal of Neuroradiology March 2023, 44 (3) 254-260; DOI: https://doi.org/10.3174/ajnr.A7779
E. Calabrese
aFrom the Department of Radiology and Biomedical Imaging (E.C., S.G., J.F.T.)
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S. Gandhi
aFrom the Department of Radiology and Biomedical Imaging (E.C., S.G., J.F.T.)
dDepartment of Radiology and Biomedical Imaging (S.G., J.F.T., E.A.), Zuckerberg San Francisco General Hospital, San Francisco, California
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J. Shih
bDepartment of Neurology (J.S., M.O., D.R., C.H., E.A.), Weill Institute for Neurosciences
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M. Otero
bDepartment of Neurology (J.S., M.O., D.R., C.H., E.A.), Weill Institute for Neurosciences
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D. Randazzo
bDepartment of Neurology (J.S., M.O., D.R., C.H., E.A.), Weill Institute for Neurosciences
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C. Hemphill
bDepartment of Neurology (J.S., M.O., D.R., C.H., E.A.), Weill Institute for Neurosciences
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R. Huie
cDepartment of Neurological Surgery (R.H.), University of California, San Francisco, San Francisco, California
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J.F. Talbott
aFrom the Department of Radiology and Biomedical Imaging (E.C., S.G., J.F.T.)
dDepartment of Radiology and Biomedical Imaging (S.G., J.F.T., E.A.), Zuckerberg San Francisco General Hospital, San Francisco, California
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E. Amorim
bDepartment of Neurology (J.S., M.O., D.R., C.H., E.A.), Weill Institute for Neurosciences
dDepartment of Radiology and Biomedical Imaging (S.G., J.F.T., E.A.), Zuckerberg San Francisco General Hospital, San Francisco, California
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  • FIG 1.
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    FIG 1.

    Frequency of hypoxic-ischemic brain injury in both outcome groups. Colorized 3D brain renderings show the frequency of injury (as defined by ADC < 650 × 10–6 mm2/s) for the poor-outcome group (A) and the good outcome group (B), respectively. The color bar (right) indicates the frequency of injury across the whole brain. Note that regions with <5% injury frequency are transparent to allow better visualization of more frequently injured areas.

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    FIG 2.

    Results of voxelwise comparisons between outcome groups. Statistically significant voxels (family-wise error rate–corrected, P < .05) are shown as color overlays on orthogonal slices of the Montreal Neurologic Institute brain atlas (A–C). Color indicates the P value for the comparison (see the color bar). A volume-rendering of the P value from a lateral perspective is also shown, with dashed yellow lines indicating the plane of axial and coronal slices (D).

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    FIG 3.

    Loading values for PC2 from the PCA. Each cortical region from the Harvard Oxford brain atlas is colored according to its PC2 loading value. Red and blue loadings indicate opposite patterns of loading (red indicates positive correlation, blue indicates a negative correlation). The dashed yellow line on the lateral projection (right) indicates the plane of the axial section (center).

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    FIG 4.

    ROC analysis of different diffusion-weighted MR imaging–based variables for predicting outcome in patients with post–cardiac arrest coma. OHCA indicates out of hospital cardiac arrest.

Tables

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  • Subject demographics stratified by outcome group

    VariableFollows Commands (n = 17)Does Not Follow Commands (n = 64)P Value
    Age (mean) (yr)55 (SD, 16)57 (SD, 15).741
    Female sex4/17 (24%)18/64 (28%).701
    Race and ethnicitya.757
     Asian4 (21%)6 (9%)
     Black3 (16%)14 (22%)
     Hispanic2 (11%)6 (9%)
     Hawaiian0 (0%)2 (3%)
     Non-Hispanic white2 (11%)6 (9%)
     Unknown8 (42%)30 (47%)
    Time from ROSC to MR imaging (mean) (hr)120 (SD, 26)115 (SD, 27).496
    Shockable rhythm6/17 (35%)12/64 (19%).145
    Out-of-hospital cardiac arrest14/17 (82%)49/64 (77%).610
    Time to ROSC (mean)19 (SD, 14)24 (SD, 14).182
    • ↵a Patient race and ethnicity do not add to 100% as some patients reported more than one race and ethnicity combination.

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American Journal of Neuroradiology: 44 (3)
American Journal of Neuroradiology
Vol. 44, Issue 3
1 Mar 2023
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Cite this article
E. Calabrese, S. Gandhi, J. Shih, M. Otero, D. Randazzo, C. Hemphill, R. Huie, J.F. Talbott, E. Amorim
Parieto-Occipital Injury on Diffusion MRI Correlates with Poor Neurologic Outcome following Cardiac Arrest
American Journal of Neuroradiology Mar 2023, 44 (3) 254-260; DOI: 10.3174/ajnr.A7779

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DWI and Neurologic Outcome Post-Arrest
E. Calabrese, S. Gandhi, J. Shih, M. Otero, D. Randazzo, C. Hemphill, R. Huie, J.F. Talbott, E. Amorim
American Journal of Neuroradiology Mar 2023, 44 (3) 254-260; DOI: 10.3174/ajnr.A7779
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