The Potential of Diffusion-Weighted Magnetic Resonance Imaging for Predicting the Outcomes of Chronic Subdural Hematomas
- Authors
- Lee, Seung-Hwan; Choi, Jong-Il; Lim, Dong-Jun; Ha, Sung-Kon; Kim, Sang-Dae; Kim, Se-Hoon
- Issue Date
- 1월-2018
- Publisher
- KOREAN NEUROSURGICAL SOC
- Keywords
- Hematoma; Subdural; Chronic; Diffusion magnetic resonance imaging
- Citation
- JOURNAL OF KOREAN NEUROSURGICAL SOCIETY, v.61, no.1, pp.97 - 104
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- JOURNAL OF KOREAN NEUROSURGICAL SOCIETY
- Volume
- 61
- Number
- 1
- Start Page
- 97
- End Page
- 104
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/78509
- DOI
- 10.3340/jkns.2016.0606.005
- ISSN
- 2005-3711
- 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.
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