Association between quantitative analysis of cerebral edema using CT imaging and neurological outcomes in cardiac arrest survivors

To determine if the density distribution proportion of Hounsfield unit (HUdp) in head computed tomography (HCT) images can be used to quantitatively measure cerebral edema in survivors of out-of-hospital cardiac arrest (OHCA). This retrospective observational study included adult comatose OHCA survi...

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Bibliographic Details
Published in:The American journal of emergency medicine 2024-04, Vol.78, p.22-28
Main Authors: In, Yong Nam, Kim, Ho Il, Park, Jung Soo, Kang, Changshin, You, Yeonho, Min, Jin Hong, Lee, Dongyoung, Lee, In Ho, Jeong, Hye Seon, Lee, Byung Kook, Lee, Jae Kwang
Format: Article
Language:English
Subjects:
Adult
Brain
Brain Edema - complications
Brain Edema - etiology
Cardiac arrest
Cardiopulmonary resuscitation
Cerebral oedema
Cohort Studies
Computed tomography
CPR
Cytotoxicity
Edema
Emergency medical care
Extracorporeal membrane oxygenation
Heart
Heart arrest
Humans
Intracranial pressure
Medical prognosis
Observational studies
Out-of-Hospital Cardiac Arrest - complications
Out-of-Hospital Cardiac Arrest - diagnostic imaging
Out-of-Hospital Cardiac Arrest - therapy
Patients
Prognosis
Quantitative analysis
Regression analysis
Retrospective Studies
Scanners
Software
Statistical analysis
Survivor
Survivors
Tomography, X-Ray Computed - methods
Traumatic brain injury
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Summary:To determine if the density distribution proportion of Hounsfield unit (HUdp) in head computed tomography (HCT) images can be used to quantitatively measure cerebral edema in survivors of out-of-hospital cardiac arrest (OHCA). This retrospective observational study included adult comatose OHCA survivors who underwent HCT within 6 h (first) and 72–96 h (second), all performed using the same CT scanner. Semi-automated quantitative analysis was used to identify differences in HUdp at specific HU ranges across the intracranial component based on neurological outcome. Cerebral edema was defined as the increased displacement of the sum of HUdp values (ΔHUdp) at a specific range between two HCT scans. Poor neurological outcome was defined as cerebral performance categories 3–5 at 6 months after OHCA. Twenty-three (42%) out of 55 patients had poor neurological outcome. Significant HUdp differences were observed between good and poor neurological outcomes in the second HCT scan at HU = 1–14, 23–35, and 39–56 (all P 
ISSN:0735-6757
1532-8171
1532-8171
DOI:10.1016/j.ajem.2023.12.036