Journal
CURRENT OPINION IN CRITICAL CARE
Volume 29, Issue 3, Pages 192-198Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MCC.0000000000001032
Keywords
cardiac arrest; hypoxic-ischemic encephalopathy; MRI; neuroimaging
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Cardiac arrest survivors often suffer from consciousness disorders, and neuroimaging techniques such as CT and MRI are vital for predicting long-term neurological outcomes. Recent studies have explored qualitative and quantitative analysis methods, but further standardization is needed.
Purpose of reviewMany patients who survive a cardiac arrest have a disorder of consciousness in the period after resuscitation, and prediction of long-term neurologic outcome requires multimodal assessments. Brain imaging with computed tomography (CT) and MRI is a key component. We aim to provide an overview of the types of neuroimaging available and their uses and limitations.Recent findingsRecent studies have evaluated qualitative and quantitative techniques to analyze and interpret CT and MRI to predict both good and poor outcomes. Qualitative interpretation of CT and MRI is widely available but is limited by low inter-rater reliability and lack of specificity around which findings have the highest correlation with outcome. Quantitative analysis of CT (gray-white ratio) and MRI (amount of brain tissue with an apparent diffusion coefficient below certain thresholds) hold promise, though additional research is needed to standardize the approach.Brain imaging is important for evaluating the extent of neurologic injury after cardiac arrest. Future work should focus on addressing previous methodological limitations and standardizing approaches to qualitative and quantitative imaging analysis. Novel imaging techniques are being developed and new analytical methods are being applied to advance the field.
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