The Potential of Diffusion-Weighted Magnetic Resonance Imaging for Predicting the Outcomes of Chronic Subdural Hematomas
10.3340/jkns.2016.0606.005
- Author:
Seung Hwan LEE
1
;
Jong Il CHOI
;
Dong Jun LIM
;
Sung Kon HA
;
Sang Dae KIM
;
Se Hoon KIM
Author Information
1. Department of Neurosurgery, Korea University Medical Center, Ansan, Korea.
- Publication Type:Original Article
- Keywords:
Hematoma, Subdural, Chronic;
Diffusion magnetic resonance imaging
- MeSH:
Diffusion Magnetic Resonance Imaging;
Drainage;
Hematoma;
Hematoma, Subdural;
Hematoma, Subdural, Chronic;
Humans;
Magnetic Resonance Imaging;
Natural History;
Stroke;
Treatment Failure
- From:Journal of Korean Neurosurgical Society
2018;61(1):97-104
- CountryRepublic of Korea
- Language:English
-
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.
