학술논문
목표 체온 조절 치료를 받은 심정지 환자에서의 예후 평가 도구로서 뇌 MRI T2 weighted image에서의 회색질과 백색질 신호 강도 비의 유용성: 선행연구
Utility of white matter to gray matter signal intensity ratio in comatose patients treated by targeted temperature management after cardiac arrest: a preliminary study
Utility of white matter to gray matter signal intensity ratio in comatose patients treated by targeted temperature management after cardiac arrest: a preliminary study
Document Type
Article
Author
금경탁 / Kyoung Tak Keum; 김용환 / Yong Hwan Kim; 황성연 / Seong Youn Hwang; 이준호 / Jun Ho Lee; 이동우 / Dong Woo Lee; 송윤규 / Yun Gyu Song; 이정화 / Jung Hwa Lee; 이경렬 / Kyoung Yul Lee
Source
대한응급의학회지 / Journal of the Korean Society of Emergency Medicine. Oct 31, 2019 30(5):437
Subject
Language
Korean
English
English
ISSN
1226-4334
Abstract
Objective: This study examined the efficacy of the white matter (WM) to gray matter (GM) signal intensity ratio (SIR) in predicting the clinical prognosis of cardiac arrest patients. Methods: Thirty-one patients who were resuscitated from cardiac arrest and underwent brain magnetic resonance imaging (MRI) were investigated retrospectively. Thirty one subjects with normal brain MRI findings served as the controls. The signal intensities (SI) were measured on T2-weighted image (T2WI). The circular regions of measurement (2-10 mm2) were placed over the regions of interest, and the average signals in GM and WM were recorded in the caudate nucleus (CN), putamen, anterior limb of the internal capsule, corpus callosum (CC), and in the cortex and WM of the frontal lobe. Cerebral performance category (CPC) 1-2 were classified as a good prognosis, and CPC 3-5 were classified as a poor prognosis. Results: Most combinations of the SIR of WM to GM and most SIs of GM, except the frontal cortex, were significantly different between the two groups. On the other hand, the SI of WM was insignificant between both groups. In receiver operating characteristic (ROC) curve analysis, the SIR of the CC to CN had an area under the ROC curve (AUROC) of 1.00 for a cut-off value of 1.59 (sensitivity, 100%; specificity, 100%), the SIR of the CC to putamen had also an AUROC of 1.00 for a cut-off value of 1.43 (sensitivity, 100%; specificity, 100%). Conclusion: The SIR of WM to GM measured on a T2WI is related to the neurological outcome after a cardiac arrest.