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. 2022 May 26:2022:5985806.
doi: 10.1155/2022/5985806. eCollection 2022.

The Evaluation Value of Diffusion-Weighted Imaging for Brain Injury in Patients after Deep Hypothermic Circulatory Arrest

Jiaxiang Zhuang  1 , Xiandong Lin  1 , Jianbing Lin  2 , Shun Yu  3 , Shuangbo Dai  2 , Licheng Yan  1 , Yuanxiang Chen  1 , Ren Wang  1
Affiliations

The Evaluation Value of Diffusion-Weighted Imaging for Brain Injury in Patients after Deep Hypothermic Circulatory Arrest

Jiaxiang Zhuang et al. Contrast Media Mol Imaging. .

Abstract

Objective: Cerebral complications may occur after surgery with deep hypothermic circulatory arrest (DHCA). Diffusion-weighted imaging (DWI) has shown promising results in detecting early changes of cerebral ischemia. However, studies in human models are limited. Here, we examined the significance of DWI for detecting brain injury in postoperative patients after DHCA.

Methods: Twelve patients who had undergone selective cerebral perfusion with DHCA were enrolled. All patients underwent magnetic resonance imaging (MRI) examinations before and after the operation with T1-weighted phase (T1W) and T2-weighted phase (T2W). Magnetic resonance angiography (3D TOF) was applied to observe intracranial arterial communication situations. DWI was employed to calculate the apparent diffusion coefficient (ADC) values. The neurocognitive function of patients was assessed preoperatively and postoperatively using the Montreal Cognitive Assessment Scale (MoCA), Hamilton Depression Scale (HAMD), and Hamilton Anxiety Scale (HAMA).

Results: The ADC values of the whole brain of patients after surgery were significantly higher than before surgery (P = 0.003). However, no significant difference in the ADC values of other regions before and after the operation was observed. There was no significant effect on the postoperative cognitive function of patients after surgery, but visual-spatial and executive abilities were significantly reduced, while psychological anxiety (P = 0.005) and depression levels (P < 0.05) significantly increased. Correlation analysis revealed a significant association between ADC change values and depression change values (P < 0.05).

Conclusion: DHCA demonstrated no significant effect on the cognitive function of patients but could affect the mood of patients. On the other hand, DWI demonstrated promising efficiency and accuracy in evaluating brain injury after DHCA.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Diffusion-weighted imaging of each plane of the brain before surgery (a) Plane of cerebellum DWI (b) Plane of cerebellum ADC (c) Basal ganglia plane DWI (d) Basal ganglia plane ADC (e) Occipital plane DWI (f) Occipital plane ADC (g) Parietal plane DWI (h) Parietal plane ADC.
Figure 2
Figure 2
Correlation analysis between ADC values and neuropsychological function.
See this image and copyright information in PMC

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