The potential of diffusion-weighted magnetic resonance imaging for predicting the outcomes of chronic subdural hematomas

Seung Hwan Lee, Jong Il Choi, Dong Jun Lim, Sung Kon Ha, Sang Dae Kim, Se Hoon Kim

Research output: Contribution to journalArticle

1 Citation (Scopus)

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.

Original languageEnglish
Pages (from-to)97-104
Number of pages8
JournalJournal of Korean Neurosurgical Society
Volume61
Issue number1
DOIs
Publication statusPublished - 2018 Jan

Keywords

  • Diffusion magnetic resonance imaging
  • Hematoma, subdural, chronic

ASJC Scopus subject areas

  • Surgery
  • Neuroscience(all)
  • Clinical Neurology

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