Artikel
Diffusion tensor imaging in comatose patients
Diffusion tensor imaging bei bewusstlosen Patienten
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Autoren
Veröffentlicht: | 23. April 2004 |
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Gliederung
Text
Objective
Diffusion weighted imaging (DWI) is a magnetic resonance sequence to examine the integrity of neuronal cells. 3 D-sequences of DWI visualizes the functional integrity of the major cerebral tracts (Diffusion tensor imaging, DTI). This study analyses the predictive quality of DTI in comatose patients.
Methods
In 12 patients after intracranial hemorrhage, DTI was performed within 8 days after the onset of coma. Coma grades were defined according to the Bruessel Coma Scale. Final analysis measured the density of tracts with supratentorial origin, paasing the brain stem in the caudal direction (type 1) and of tracts with infratentorial orign, passing the brain stem in the rostral direction (type 2).
Results
1. when tracts of type 1 and 2 were visualized in a normal densitiy all over the brain stem, patients stayed in coma I not longer than 5 days and always survived. 2. when tracts of type 1 and 2 were totally interrupted on the mesencephalic level, patients were in coma II or III for 8 days avaeragely and developed persitent vegetative state. 3. when tracts of type 1 stopped at the level of the upper mesencephalon and those of type 2 at the level of the lower pons, patients were in coma III or IV and mortality was 100%. 4. when no tracts could be visualized all over the brain, patients were in brain death.
Conclusions
Diffusion tensor imaging is of a high by predictive value in coma.