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Value of conventional, and diffusion- and perfusion weighted MRI in the management of patients with unclear cerebral pathology, admitted to the intensive care unit

Sundgren, Pia LU ; Reinstrup, Peter LU ; Romner, Bertil LU ; Holtås, Stig LU and Maly, Pavel LU (2002) In Neuroradiology 44(8). p.674-680
Abstract
The aim of our retrospective study was to determine the extent to which diffusion- and perfusion- weighted MRI combined with conventional MRI could be helpful in the evaluation of intensive care unit (ICU) patients who have unknown or unclear cerebral pathology underlying a serious clinical condition. Twenty-one ICU patients with disparity between the findings on brain CT scan and their clinical status were studied. All patients underwent conventional MR and diffusion-weighted imaging and 14 also had MR perfusion studies. Abnormalities were present on diffusion-weighted imaging of 17 of the 21 patients and on perfusion-weighted studies of 7 of 14 patients. The MRI results changed the preliminary/working diagnosis in six patients. In eight... (More)
The aim of our retrospective study was to determine the extent to which diffusion- and perfusion- weighted MRI combined with conventional MRI could be helpful in the evaluation of intensive care unit (ICU) patients who have unknown or unclear cerebral pathology underlying a serious clinical condition. Twenty-one ICU patients with disparity between the findings on brain CT scan and their clinical status were studied. All patients underwent conventional MR and diffusion-weighted imaging and 14 also had MR perfusion studies. Abnormalities were present on diffusion-weighted imaging of 17 of the 21 patients and on perfusion-weighted studies of 7 of 14 patients. The MRI results changed the preliminary/working diagnosis in six patients. In eight other patients, MRI revealed additional pathology that had not been suspected clinically, and/or characterized more closely findings that had already been detected by CT or suspected clinically. MRI showed abnormalities in four of the five patients who had normal CT. MRI findings suggested a negative clinical outcome in all nine patients who subsequently died. MRI findings also suggested positive long-term outcome in five of nine patients who improved significantly as based on Glasgow and extended Glasgow outcome scales. In the three unconscious patients who had normal diffusion- and perfusion weighted imaging the clinical outcome was good. This study suggests that MRI in seriously ill ICU patients with unclear cerebral pathology can provide information that changes, characterizes, or supports diagnoses and/or prognoses and therefore facilitates further management. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
perfusion-weighted studies, diffusion-weighted imaging, brain injury, magnetic resonance imaging
in
Neuroradiology
volume
44
issue
8
pages
674 - 680
publisher
Springer Verlag
external identifiers
  • wos:000177751000005
  • pmid:12185545
  • scopus:0036939528
ISSN
1432-1920
DOI
10.1007/s00234-002-0777-z
language
English
LU publication?
yes
id
22fd1645-dcbe-43b3-9f5b-c96b48fd8942 (old id 329415)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/12185545
http://link.springer.com/article/10.1007%2Fs00234-002-0777-z
date added to LUP
2007-11-15 09:41:57
date last changed
2017-01-01 04:23:25
@article{22fd1645-dcbe-43b3-9f5b-c96b48fd8942,
  abstract     = {The aim of our retrospective study was to determine the extent to which diffusion- and perfusion- weighted MRI combined with conventional MRI could be helpful in the evaluation of intensive care unit (ICU) patients who have unknown or unclear cerebral pathology underlying a serious clinical condition. Twenty-one ICU patients with disparity between the findings on brain CT scan and their clinical status were studied. All patients underwent conventional MR and diffusion-weighted imaging and 14 also had MR perfusion studies. Abnormalities were present on diffusion-weighted imaging of 17 of the 21 patients and on perfusion-weighted studies of 7 of 14 patients. The MRI results changed the preliminary/working diagnosis in six patients. In eight other patients, MRI revealed additional pathology that had not been suspected clinically, and/or characterized more closely findings that had already been detected by CT or suspected clinically. MRI showed abnormalities in four of the five patients who had normal CT. MRI findings suggested a negative clinical outcome in all nine patients who subsequently died. MRI findings also suggested positive long-term outcome in five of nine patients who improved significantly as based on Glasgow and extended Glasgow outcome scales. In the three unconscious patients who had normal diffusion- and perfusion weighted imaging the clinical outcome was good. This study suggests that MRI in seriously ill ICU patients with unclear cerebral pathology can provide information that changes, characterizes, or supports diagnoses and/or prognoses and therefore facilitates further management.},
  author       = {Sundgren, Pia and Reinstrup, Peter and Romner, Bertil and Holtås, Stig and Maly, Pavel},
  issn         = {1432-1920},
  keyword      = {perfusion-weighted studies,diffusion-weighted imaging,brain injury,magnetic resonance imaging},
  language     = {eng},
  number       = {8},
  pages        = {674--680},
  publisher    = {Springer Verlag},
  series       = {Neuroradiology},
  title        = {Value of conventional, and diffusion- and perfusion weighted MRI in the management of patients with unclear cerebral pathology, admitted to the intensive care unit},
  url          = {http://dx.doi.org/10.1007/s00234-002-0777-z},
  volume       = {44},
  year         = {2002},
}