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Evolution of diffusion tensor imaging parameters after acute subarachnoid haemorrhage: a prospective cohort study

  • Diagnostic Neuroradiology
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Abstract

Introduction

Few studies assessed diffusion tensor imaging (DTI) changes in the acute phase of subarachnoid haemorrhage (SAH). We prospectively evaluated DTI parameters in the acute phase of SAH and 8–10 days after and analysed whether changes could be related to SAH severity or to the development of delayed cerebral ischemia (DCI).

Methods

Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) changes over time were assessed in a prospective cohort of patients with acute SAH. Two MRI studies were performed at <72 h (MRI-1) and 8–10 days (MRI-2). DTI parameters were recorded in 15 ROIs. Linear mixed regression models were used.

Results

Forty-two patients were included. Subtle changes in DTI parameters were found between MRI-1 and MRI-2. At the posterior limb of internal capsule (PLIC), a weak evidence of a 0.02 mean increase in FA (p = 0.064) and a 17.55 × 10−6 mm2/s decrease in ADC (p = 0.052) were found in MRI-2. Both FA and ADC changed over time at the cerebellum (increase of 0.03; p = 0.017; decrease of 34.73 × 10−6 mm2/s; p = 0.002, respectively). Patients with DCI had lower FA values on MRI-1 and lower ADC on MRI-2, although not reaching statistical significance, compared to non-DCI patients. DTI parameters on MRI-1 were not correlated to clinical admission scales.

Conclusion

ADC and FA values show subtle changes over time in acute SAH at the PLIC and cerebellum although not statistically associated with the severity of SAH or the occurrence of DCI. However, DTI changes occurred mainly in DCI patients, suggesting a possible role of DTI as a marker of DCI.

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Acknowledgements

We would like to thank the medical and nursing staff of Serviço de Cuidados Neurocríticos and Unidade Cerebro-Vascular at Hospital de São José, and the Neuroradiology Department physicians and technicians for collaboration during patient inclusion. We also thank Dr.Rui Marcelino for helping with the database. Dr. Fragata was supported by a grant of the Sociedade Portuguesa de AVC (SPAVC) sponsored by Tecnifar.

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Authors and Affiliations

  1. Serviço de Neurorradiologia, Centro Hospitalar Lisboa Central, Hospital São José, Rua José António Serrano, Lisbon, 1150-045, Portugal

    Isabel Fragata

  2. NOVA Medical School, Lisbon, Portugal

    Isabel Fragata

  3. Department of Neurosciences and Mental Health, Neurology, Hospital de Santa Maria, CHLN, Lisbon, Portugal

    Patrícia Canhão

  4. Faculty of Medicine, University of Lisbon, Lisbon, Portugal

    Patrícia Canhão

  5. Epidemiology and Statistics Unit, Centro Hospitalar Lisboa Central, Lisbon, Portugal

    Marta Alves & Ana Luísa Papoila

  6. Neuroradiology Section, Centre for Imaging and Function, University Hospital, Uppsala, Sweden

    Nuno Canto-Moreira

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  1. Isabel Fragata
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  3. Marta Alves
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  4. Ana Luísa Papoila
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  5. Nuno Canto-Moreira
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Corresponding author

Correspondence to Isabel Fragata.

Ethics declarations

We declare that all human and animal studies have been approved by the CHLC Ethics Committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

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We declare that we have no conflict of interest..

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Fragata, I., Canhão, P., Alves, M. et al. Evolution of diffusion tensor imaging parameters after acute subarachnoid haemorrhage: a prospective cohort study. Neuroradiology 59, 13–21 (2017). https://doi.org/10.1007/s00234-016-1774-y

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  • DOI: https://doi.org/10.1007/s00234-016-1774-y

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