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Diffusion imaging may predict reversible brain lesions in eclampsia and severe preeclampsia: initial experience
The purpose of this study was to validate diffusion-weighted magnetic resonance imaging in the prediction of the evolutive course of brain edema and to establish its pathophysiologic presence in patients with eclampsia/severe preeclampsia. Seventeen patients with a clinical diagnosis of severe eclam...
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| Published in: | American journal of obstetrics and gynecology 2003-11, Vol.189 (5), p.1350-1355 |
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| Main Authors: | , , , , , , , , , |
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| Language: | English |
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| cites | cdi_FETCH-LOGICAL-c509t-244d8ca7c20d296bc388050bd528ea806486b530ba767257e53bccf86eaf8cc53 |
| container_end_page | 1355 |
| container_issue | 5 |
| container_start_page | 1350 |
| container_title | American journal of obstetrics and gynecology |
| container_volume | 189 |
| creator | Loureiro, Ricardo Leite, Claudia C Kahhale, Soubhi Freire, Sálvio Sousa, Benesson Cardoso, Ellison F Alves, Eliane A Borba, Paulo Cerri, Giovanni G Zugaib, Marcelo |
| description | The purpose of this study was to validate diffusion-weighted magnetic resonance imaging in the prediction of the evolutive course of brain edema and to establish its pathophysiologic presence in patients with eclampsia/severe preeclampsia.
Seventeen patients with a clinical diagnosis of severe eclampsia/preeclampsia and T2 hyperintense brain lesions on routine magnetic resonance imaging were evaluated at hospital admission and 8 weeks later.
Brain edema was reversible in 13 patients and irreversible in 4 patients, as indicated on follow-up magnetic resonance imaging. Sixteen of 17 patients were differentiated accurately into reversible and irreversible groups on the basis of diffusion imaging on hospital admission. Diffusion-weighted magnetic resonance imaging demonstrated a significant increase in water mobility in abnormal regions compared with normal-appearing brains in patients in the reversible group (1.34±0.10 mm
2 vs 0.79±0.08 mm
2/s×10
−3,
P |
| doi_str_mv | 10.1067/S0002-9378(03)00651-3 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_71393996</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0002937803006513</els_id><sourcerecordid>71393996</sourcerecordid><originalsourceid>FETCH-LOGICAL-c509t-244d8ca7c20d296bc388050bd528ea806486b530ba767257e53bccf86eaf8cc53</originalsourceid><addsrcrecordid>eNqFkEtP3DAURi1UxExpfwLIm6J2EXoTx4-wQdW0BSQkFtC15dzcjFzlVTuDmH_fZGYES1Z-6HzfvTqMnaVwmYLS3x8BIEsKoc1XEN8AlEwTccSWKRQ6UUaZD2z5iizYxxj_zs-syE7YIs2VyKXSS9b_9HW9ib7vuG_d2ndr3rotHwJVHkce6JlC9GVDvAzOd7yhmY18uhI2rh2id9x1FY8zSXPw9f9qovzoXcPpZaDgqUP6xI5r10T6fDhP2Z_fv55Wt8n9w83d6sd9ghKKMcnyvDLoNGZQZYUqURgDEspKZoacAZUbVUoBpdNKZ1KTFCVibRS52iBKccou9r1D6P9tKI629RGpaVxH_SZanYpCFIWaQLkHMfQxBqrtECYTYWtTsLNpuzNtZ40WhN2ZtmLKnR8GbMqWqrfUQe0EfDkALqJr6uA69PGNk0IagLnoes_RpOPZU7ARd6oqHwhHW_X-nVX-A7_0nFo</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>71393996</pqid></control><display><type>article</type><title>Diffusion imaging may predict reversible brain lesions in eclampsia and severe preeclampsia: initial experience</title><source>Elsevier</source><creator>Loureiro, Ricardo ; Leite, Claudia C ; Kahhale, Soubhi ; Freire, Sálvio ; Sousa, Benesson ; Cardoso, Ellison F ; Alves, Eliane A ; Borba, Paulo ; Cerri, Giovanni G ; Zugaib, Marcelo</creator><creatorcontrib>Loureiro, Ricardo ; Leite, Claudia C ; Kahhale, Soubhi ; Freire, Sálvio ; Sousa, Benesson ; Cardoso, Ellison F ; Alves, Eliane A ; Borba, Paulo ; Cerri, Giovanni G ; Zugaib, Marcelo</creatorcontrib><description>The purpose of this study was to validate diffusion-weighted magnetic resonance imaging in the prediction of the evolutive course of brain edema and to establish its pathophysiologic presence in patients with eclampsia/severe preeclampsia.
Seventeen patients with a clinical diagnosis of severe eclampsia/preeclampsia and T2 hyperintense brain lesions on routine magnetic resonance imaging were evaluated at hospital admission and 8 weeks later.
Brain edema was reversible in 13 patients and irreversible in 4 patients, as indicated on follow-up magnetic resonance imaging. Sixteen of 17 patients were differentiated accurately into reversible and irreversible groups on the basis of diffusion imaging on hospital admission. Diffusion-weighted magnetic resonance imaging demonstrated a significant increase in water mobility in abnormal regions compared with normal-appearing brains in patients in the reversible group (1.34±0.10 mm
2 vs 0.79±0.08 mm
2/s×10
−3,
P<.001). In the irreversible group, restricted water diffusion was present, which was consistent with cytotoxic edema and early brain infarction in 3 of 4 patients.
Diffusion-weighted magnetic resonance imaging can predict successfully the evolutive course of brain edema in an acute setting in these patients. Our findings indicate that brain edema is vasogenic, although ischemic/cytotoxic edema was observed less commonly.</description><identifier>ISSN: 0002-9378</identifier><identifier>EISSN: 1097-6868</identifier><identifier>DOI: 10.1067/S0002-9378(03)00651-3</identifier><identifier>PMID: 14634567</identifier><identifier>CODEN: AJOGAH</identifier><language>eng</language><publisher>Philadelphia, PA: Mosby, Inc</publisher><subject>Adolescent ; Adult ; Biological and medical sciences ; Brain - pathology ; Brain - physiopathology ; brain edema ; Brain Edema - diagnosis ; Brain Edema - etiology ; Brain Edema - physiopathology ; diffusion imaging ; Diffusion Magnetic Resonance Imaging ; Diseases of mother, fetus and pregnancy ; Eclampsia ; Eclampsia - complications ; Eclampsia - diagnosis ; Female ; Gynecology. Andrology. Obstetrics ; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy ; Humans ; Magnetic Resonance Imaging ; Medical sciences ; Nervous system (semeiology, syndromes) ; Neurology ; posterior leukoencephalopathy syndrome ; Pre-Eclampsia - complications ; Pre-Eclampsia - diagnosis ; Pregnancy ; Pregnancy. Fetus. Placenta ; Prognosis ; Sensitivity and Specificity ; Severity of Illness Index</subject><ispartof>American journal of obstetrics and gynecology, 2003-11, Vol.189 (5), p.1350-1355</ispartof><rights>2003 Mosby, Inc.</rights><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c509t-244d8ca7c20d296bc388050bd528ea806486b530ba767257e53bccf86eaf8cc53</citedby><cites>FETCH-LOGICAL-c509t-244d8ca7c20d296bc388050bd528ea806486b530ba767257e53bccf86eaf8cc53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15358003$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14634567$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Loureiro, Ricardo</creatorcontrib><creatorcontrib>Leite, Claudia C</creatorcontrib><creatorcontrib>Kahhale, Soubhi</creatorcontrib><creatorcontrib>Freire, Sálvio</creatorcontrib><creatorcontrib>Sousa, Benesson</creatorcontrib><creatorcontrib>Cardoso, Ellison F</creatorcontrib><creatorcontrib>Alves, Eliane A</creatorcontrib><creatorcontrib>Borba, Paulo</creatorcontrib><creatorcontrib>Cerri, Giovanni G</creatorcontrib><creatorcontrib>Zugaib, Marcelo</creatorcontrib><title>Diffusion imaging may predict reversible brain lesions in eclampsia and severe preeclampsia: initial experience</title><title>American journal of obstetrics and gynecology</title><addtitle>Am J Obstet Gynecol</addtitle><description>The purpose of this study was to validate diffusion-weighted magnetic resonance imaging in the prediction of the evolutive course of brain edema and to establish its pathophysiologic presence in patients with eclampsia/severe preeclampsia.
Seventeen patients with a clinical diagnosis of severe eclampsia/preeclampsia and T2 hyperintense brain lesions on routine magnetic resonance imaging were evaluated at hospital admission and 8 weeks later.
Brain edema was reversible in 13 patients and irreversible in 4 patients, as indicated on follow-up magnetic resonance imaging. Sixteen of 17 patients were differentiated accurately into reversible and irreversible groups on the basis of diffusion imaging on hospital admission. Diffusion-weighted magnetic resonance imaging demonstrated a significant increase in water mobility in abnormal regions compared with normal-appearing brains in patients in the reversible group (1.34±0.10 mm
2 vs 0.79±0.08 mm
2/s×10
−3,
P<.001). In the irreversible group, restricted water diffusion was present, which was consistent with cytotoxic edema and early brain infarction in 3 of 4 patients.
Diffusion-weighted magnetic resonance imaging can predict successfully the evolutive course of brain edema in an acute setting in these patients. Our findings indicate that brain edema is vasogenic, although ischemic/cytotoxic edema was observed less commonly.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Brain - pathology</subject><subject>Brain - physiopathology</subject><subject>brain edema</subject><subject>Brain Edema - diagnosis</subject><subject>Brain Edema - etiology</subject><subject>Brain Edema - physiopathology</subject><subject>diffusion imaging</subject><subject>Diffusion Magnetic Resonance Imaging</subject><subject>Diseases of mother, fetus and pregnancy</subject><subject>Eclampsia</subject><subject>Eclampsia - complications</subject><subject>Eclampsia - diagnosis</subject><subject>Female</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging</subject><subject>Medical sciences</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>posterior leukoencephalopathy syndrome</subject><subject>Pre-Eclampsia - complications</subject><subject>Pre-Eclampsia - diagnosis</subject><subject>Pregnancy</subject><subject>Pregnancy. Fetus. Placenta</subject><subject>Prognosis</subject><subject>Sensitivity and Specificity</subject><subject>Severity of Illness Index</subject><issn>0002-9378</issn><issn>1097-6868</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><recordid>eNqFkEtP3DAURi1UxExpfwLIm6J2EXoTx4-wQdW0BSQkFtC15dzcjFzlVTuDmH_fZGYES1Z-6HzfvTqMnaVwmYLS3x8BIEsKoc1XEN8AlEwTccSWKRQ6UUaZD2z5iizYxxj_zs-syE7YIs2VyKXSS9b_9HW9ib7vuG_d2ndr3rotHwJVHkce6JlC9GVDvAzOd7yhmY18uhI2rh2id9x1FY8zSXPw9f9qovzoXcPpZaDgqUP6xI5r10T6fDhP2Z_fv55Wt8n9w83d6sd9ghKKMcnyvDLoNGZQZYUqURgDEspKZoacAZUbVUoBpdNKZ1KTFCVibRS52iBKccou9r1D6P9tKI629RGpaVxH_SZanYpCFIWaQLkHMfQxBqrtECYTYWtTsLNpuzNtZ40WhN2ZtmLKnR8GbMqWqrfUQe0EfDkALqJr6uA69PGNk0IagLnoes_RpOPZU7ARd6oqHwhHW_X-nVX-A7_0nFo</recordid><startdate>20031101</startdate><enddate>20031101</enddate><creator>Loureiro, Ricardo</creator><creator>Leite, Claudia C</creator><creator>Kahhale, Soubhi</creator><creator>Freire, Sálvio</creator><creator>Sousa, Benesson</creator><creator>Cardoso, Ellison F</creator><creator>Alves, Eliane A</creator><creator>Borba, Paulo</creator><creator>Cerri, Giovanni G</creator><creator>Zugaib, Marcelo</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20031101</creationdate><title>Diffusion imaging may predict reversible brain lesions in eclampsia and severe preeclampsia: initial experience</title><author>Loureiro, Ricardo ; Leite, Claudia C ; Kahhale, Soubhi ; Freire, Sálvio ; Sousa, Benesson ; Cardoso, Ellison F ; Alves, Eliane A ; Borba, Paulo ; Cerri, Giovanni G ; Zugaib, Marcelo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c509t-244d8ca7c20d296bc388050bd528ea806486b530ba767257e53bccf86eaf8cc53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Brain - pathology</topic><topic>Brain - physiopathology</topic><topic>brain edema</topic><topic>Brain Edema - diagnosis</topic><topic>Brain Edema - etiology</topic><topic>Brain Edema - physiopathology</topic><topic>diffusion imaging</topic><topic>Diffusion Magnetic Resonance Imaging</topic><topic>Diseases of mother, fetus and pregnancy</topic><topic>Eclampsia</topic><topic>Eclampsia - complications</topic><topic>Eclampsia - diagnosis</topic><topic>Female</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging</topic><topic>Medical sciences</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>posterior leukoencephalopathy syndrome</topic><topic>Pre-Eclampsia - complications</topic><topic>Pre-Eclampsia - diagnosis</topic><topic>Pregnancy</topic><topic>Pregnancy. Fetus. Placenta</topic><topic>Prognosis</topic><topic>Sensitivity and Specificity</topic><topic>Severity of Illness Index</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Loureiro, Ricardo</creatorcontrib><creatorcontrib>Leite, Claudia C</creatorcontrib><creatorcontrib>Kahhale, Soubhi</creatorcontrib><creatorcontrib>Freire, Sálvio</creatorcontrib><creatorcontrib>Sousa, Benesson</creatorcontrib><creatorcontrib>Cardoso, Ellison F</creatorcontrib><creatorcontrib>Alves, Eliane A</creatorcontrib><creatorcontrib>Borba, Paulo</creatorcontrib><creatorcontrib>Cerri, Giovanni G</creatorcontrib><creatorcontrib>Zugaib, Marcelo</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of obstetrics and gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Loureiro, Ricardo</au><au>Leite, Claudia C</au><au>Kahhale, Soubhi</au><au>Freire, Sálvio</au><au>Sousa, Benesson</au><au>Cardoso, Ellison F</au><au>Alves, Eliane A</au><au>Borba, Paulo</au><au>Cerri, Giovanni G</au><au>Zugaib, Marcelo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diffusion imaging may predict reversible brain lesions in eclampsia and severe preeclampsia: initial experience</atitle><jtitle>American journal of obstetrics and gynecology</jtitle><addtitle>Am J Obstet Gynecol</addtitle><date>2003-11-01</date><risdate>2003</risdate><volume>189</volume><issue>5</issue><spage>1350</spage><epage>1355</epage><pages>1350-1355</pages><issn>0002-9378</issn><eissn>1097-6868</eissn><coden>AJOGAH</coden><abstract>The purpose of this study was to validate diffusion-weighted magnetic resonance imaging in the prediction of the evolutive course of brain edema and to establish its pathophysiologic presence in patients with eclampsia/severe preeclampsia.
Seventeen patients with a clinical diagnosis of severe eclampsia/preeclampsia and T2 hyperintense brain lesions on routine magnetic resonance imaging were evaluated at hospital admission and 8 weeks later.
Brain edema was reversible in 13 patients and irreversible in 4 patients, as indicated on follow-up magnetic resonance imaging. Sixteen of 17 patients were differentiated accurately into reversible and irreversible groups on the basis of diffusion imaging on hospital admission. Diffusion-weighted magnetic resonance imaging demonstrated a significant increase in water mobility in abnormal regions compared with normal-appearing brains in patients in the reversible group (1.34±0.10 mm
2 vs 0.79±0.08 mm
2/s×10
−3,
P<.001). In the irreversible group, restricted water diffusion was present, which was consistent with cytotoxic edema and early brain infarction in 3 of 4 patients.
Diffusion-weighted magnetic resonance imaging can predict successfully the evolutive course of brain edema in an acute setting in these patients. Our findings indicate that brain edema is vasogenic, although ischemic/cytotoxic edema was observed less commonly.</abstract><cop>Philadelphia, PA</cop><pub>Mosby, Inc</pub><pmid>14634567</pmid><doi>10.1067/S0002-9378(03)00651-3</doi><tpages>6</tpages></addata></record> |
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| identifier | ISSN: 0002-9378 |
| ispartof | American journal of obstetrics and gynecology, 2003-11, Vol.189 (5), p.1350-1355 |
| issn | 0002-9378 1097-6868 |
| language | eng |
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| source | Elsevier |
| subjects | Adolescent Adult Biological and medical sciences Brain - pathology Brain - physiopathology brain edema Brain Edema - diagnosis Brain Edema - etiology Brain Edema - physiopathology diffusion imaging Diffusion Magnetic Resonance Imaging Diseases of mother, fetus and pregnancy Eclampsia Eclampsia - complications Eclampsia - diagnosis Female Gynecology. Andrology. Obstetrics Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy Humans Magnetic Resonance Imaging Medical sciences Nervous system (semeiology, syndromes) Neurology posterior leukoencephalopathy syndrome Pre-Eclampsia - complications Pre-Eclampsia - diagnosis Pregnancy Pregnancy. Fetus. Placenta Prognosis Sensitivity and Specificity Severity of Illness Index |
| title | Diffusion imaging may predict reversible brain lesions in eclampsia and severe preeclampsia: initial experience |
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