Can Apparent Diffusion Coefficient Predict the Clinical Outcome in Drowned Children?

• Published in: Canadian Association of Radiologists journal Vol. 68; no. 2; pp. 217 - 223
• Main Authors: Hruşcã, Adrian, MD, PhD, Rãchişan, Andreea Liana, MD, PhD, Rödl, Siegfried, MD, PhD, Sorantin, Erich, MD, PhD
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA Elsevier Inc 01.05.2017; SAGE Publications; SAGE PUBLICATIONS, INC
• Subjects: Apparent diffusion coefficient; Cerebral; Child, Preschool; Children; Children & youth; Clinical outcomes; Diffusion; Diffusion coefficient; Diffusion Magnetic Resonance Imaging; Diffusion-weighted imaging; Drowning; Female; Humans; Hypoxia-Ischemia, Brain - diagnostic imaging; Hypoxia-Ischemia, Brain - etiology; Male; Near Drowning - complications; Near Drowning - diagnostic imaging; Predictions; Predictive Value of Tests; Prognosis; Radiology; Retrospective Studies; Diffusion-weighted imaging; Drowning; Cerebral; Apparent diffusion coefficient
• ISSN: 0846-5371; 1488-2361
• DOI: 10.1016/j.carj.2016.12.001

Abstract Introduction Pediatric cerebral hypoxic-ischemic injury frequently results in severe neurological outcome. Imaging with diffusion-weighted magnetic resonance imaging (DWi) demonstrates that the acute cerebral injury and apparent diffusion coefficient (ADC) allow the assessment of the severity of brain damage. The main objective was to examine if spatial distribution of reductions in ADC values is associated with clinical outcome in drowned children. Methods This is a retrospective study of 7 children (7 examinations) suffering from a hypoxic-ischemic event who underwent DWi. Seven subjects with normal DWi served as controls. The mean patient age was 4.88 ± 2.93 years and the male-to-female ratio was 5:2. The neurological outcome was divided into 2 categories: 4 children with Apallic syndrome and 3 deaths. We analysed the differences between the drowned children and the control group regarding clinical data, DWi abnormalities, and ADC values. Results The ADC values in the occipital and parietal grey matter were significantly different between the drowned children (765.14 ± 65.47 vs 920.95 ± 69.62; P  = .003) and the control group (670.82 ± 233.99 vs 900.66 ± 92.72; P  = .005). The ADC showed low values in the precentral area also ( P  = .044). Conclusion The ADC reduction may be useful to predict the poor outcome in drowned children and can be a valuable tool for clinical assessment.