Brain MR imaging and spectroscopy for outcome prognostication after pediatric cardiac arrest

Children surviving cardiac arrest are at high risk of neurological morbidity and mortality; however, there is a lack of validated prognostic biomarkers. We aimed to evaluate brain magnetic resonance imaging (MRI) and spectroscopy (MRS) as predictors of death and disability. Secondly, we evaluated wh...

Full description

Saved in:
Bibliographic Details
Published in:Resuscitation 2020-12, Vol.157, p.185-194
Main Authors: Fink, Ericka L., Wisnowski, Jessica, Clark, Robert, Berger, Rachel P., Fabio, Anthony, Furtado, Andre, Narayan, Srikala, Angus, Derek C., Watson, R. Scott, Wang, Chunyan, Callaway, Clifton W., Bell, Michael J., Kochanek, Patrick M., Bluml, Stefan, Panigrahy, Ashok
Format: Article
Language:English
Subjects:
Cardiac arrest
Magnetic resonance imaging
Magnetic resonance spectroscopy
Outcome
Pediatric
Prognostication
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c491t-46ee902803e8bd1cdab72a9ec22ab6afccd5ef6e7b60b3ade1f82d29392da2f83
cites cdi_FETCH-LOGICAL-c491t-46ee902803e8bd1cdab72a9ec22ab6afccd5ef6e7b60b3ade1f82d29392da2f83
container_end_page 194
container_issue
container_start_page 185
container_title Resuscitation
container_volume 157
creator Fink, Ericka L.
Wisnowski, Jessica
Clark, Robert
Berger, Rachel P.
Fabio, Anthony
Furtado, Andre
Narayan, Srikala
Angus, Derek C.
Watson, R. Scott
Wang, Chunyan
Callaway, Clifton W.
Bell, Michael J.
Kochanek, Patrick M.
Bluml, Stefan
Panigrahy, Ashok
description Children surviving cardiac arrest are at high risk of neurological morbidity and mortality; however, there is a lack of validated prognostic biomarkers. We aimed to evaluate brain magnetic resonance imaging (MRI) and spectroscopy (MRS) as predictors of death and disability. Secondly, we evaluated whether MRI/S by randomized group. This single center study analyzed clinically indicated brain MRI/S data from children enrolled in a randomized controlled trial of 24 vs. 72 h of hypothermia following cardiac arrest. Two pediatric radiologists scored conventional MRIs. Lactate and N-acetyl-aspartate (NAA) concentrations (mmol/kg) were determined from spectra acquired from the basal ganglia, thalamus, parietal white matter and parietooccipital gray matter. Mortality and neurological outcomes (favorable = Pediatric Cerebral Performance Category [PCPC] 1, 2, 3 or increase < 2) were assessed at hospital discharge. Non-parametric tests were used to test for associations between MRI/S biomarkers and outcome and randomized group. 23 children with (median [interquartile range]) age of 1.5 (0.3−4.0) years. Ten (44%) had favorable outcome. There were more T2 brain lesions in the lentiform nuclei in children with unfavorable 12 (92%) vs. favorable 3 (33%) outcome, p = 0.007. Increased lactate and decreased NAA concentrations in the parietooccipital gray matter and decreased NAA in the parietal white matter were associated with unfavorable outcome (p’s 
doi_str_mv 10.1016/j.resuscitation.2020.06.033
format article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7769908</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0300957220302719</els_id><sourcerecordid>2423516335</sourcerecordid><originalsourceid>FETCH-LOGICAL-c491t-46ee902803e8bd1cdab72a9ec22ab6afccd5ef6e7b60b3ade1f82d29392da2f83</originalsourceid><addsrcrecordid>eNqNkVFrFDEUhYModlv9CxLwxZcZb5KdZIIgaGlVqBSKvgkhk9xZs-xOxiRT6L8369Zi33xKIOeee3I-Ql4zaBkw-XbbJsxLdqHYEuLUcuDQgmxBiCdkxXolGtYpeEpWIAAa3Sl-Qk5z3gKA6LR6Tk4El53oFFuRHx-TDRP9ekPD3m7CtKF28jTP6EqK2cX5jo4x0bgUF_dI5xQ3U8wluD-7qR0LJjqjD7ak4KizqV4dtalmLC_Is9HuMr68P8_I98uLb-efm6vrT1_OP1w1bq1ZadYSUQPvQWA_eOa8HRS3Gh3ndpB2dM53OEpUg4RBWI9s7LnnWmjuLR97cUbeH33nZdijdziVZHdmTvVP6c5EG8zjlyn8NJt4a5SSWsPB4M29QYq_lprc7EN2uNvZCeOSDV9z0TEpRFel745SV_vJCceHNQzMgY_Zmkd8zIGPAWkqnzr96t-kD7N_gVTBxVGAta_bgMlUI5xcbThVJsbH8F-LfgMDda4z</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2423516335</pqid></control><display><type>article</type><title>Brain MR imaging and spectroscopy for outcome prognostication after pediatric cardiac arrest</title><source>Elsevier</source><creator>Fink, Ericka L. ; Wisnowski, Jessica ; Clark, Robert ; Berger, Rachel P. ; Fabio, Anthony ; Furtado, Andre ; Narayan, Srikala ; Angus, Derek C. ; Watson, R. Scott ; Wang, Chunyan ; Callaway, Clifton W. ; Bell, Michael J. ; Kochanek, Patrick M. ; Bluml, Stefan ; Panigrahy, Ashok</creator><creatorcontrib>Fink, Ericka L. ; Wisnowski, Jessica ; Clark, Robert ; Berger, Rachel P. ; Fabio, Anthony ; Furtado, Andre ; Narayan, Srikala ; Angus, Derek C. ; Watson, R. Scott ; Wang, Chunyan ; Callaway, Clifton W. ; Bell, Michael J. ; Kochanek, Patrick M. ; Bluml, Stefan ; Panigrahy, Ashok</creatorcontrib><description>Children surviving cardiac arrest are at high risk of neurological morbidity and mortality; however, there is a lack of validated prognostic biomarkers. We aimed to evaluate brain magnetic resonance imaging (MRI) and spectroscopy (MRS) as predictors of death and disability. Secondly, we evaluated whether MRI/S by randomized group. This single center study analyzed clinically indicated brain MRI/S data from children enrolled in a randomized controlled trial of 24 vs. 72 h of hypothermia following cardiac arrest. Two pediatric radiologists scored conventional MRIs. Lactate and N-acetyl-aspartate (NAA) concentrations (mmol/kg) were determined from spectra acquired from the basal ganglia, thalamus, parietal white matter and parietooccipital gray matter. Mortality and neurological outcomes (favorable = Pediatric Cerebral Performance Category [PCPC] 1, 2, 3 or increase &lt; 2) were assessed at hospital discharge. Non-parametric tests were used to test for associations between MRI/S biomarkers and outcome and randomized group. 23 children with (median [interquartile range]) age of 1.5 (0.3−4.0) years. Ten (44%) had favorable outcome. There were more T2 brain lesions in the lentiform nuclei in children with unfavorable 12 (92%) vs. favorable 3 (33%) outcome, p = 0.007. Increased lactate and decreased NAA concentrations in the parietooccipital gray matter and decreased NAA in the parietal white matter were associated with unfavorable outcome (p’s &lt; 0.05). There were no differences for any biomarker by randomized group. Regional cerebral and metabolic MRI/S biomarkers are predictive of neurological outcomes at hospital discharge in pediatric cardiac arrest and should undergo validation testing in a large sample.</description><identifier>ISSN: 0300-9572</identifier><identifier>EISSN: 1873-1570</identifier><identifier>DOI: 10.1016/j.resuscitation.2020.06.033</identifier><identifier>PMID: 32653571</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>Cardiac arrest ; Magnetic resonance imaging ; Magnetic resonance spectroscopy ; Outcome ; Pediatric ; Prognostication</subject><ispartof>Resuscitation, 2020-12, Vol.157, p.185-194</ispartof><rights>2020 Elsevier B.V.</rights><rights>Copyright © 2020 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c491t-46ee902803e8bd1cdab72a9ec22ab6afccd5ef6e7b60b3ade1f82d29392da2f83</citedby><cites>FETCH-LOGICAL-c491t-46ee902803e8bd1cdab72a9ec22ab6afccd5ef6e7b60b3ade1f82d29392da2f83</cites><orcidid>0000-0002-3683-4571</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32653571$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fink, Ericka L.</creatorcontrib><creatorcontrib>Wisnowski, Jessica</creatorcontrib><creatorcontrib>Clark, Robert</creatorcontrib><creatorcontrib>Berger, Rachel P.</creatorcontrib><creatorcontrib>Fabio, Anthony</creatorcontrib><creatorcontrib>Furtado, Andre</creatorcontrib><creatorcontrib>Narayan, Srikala</creatorcontrib><creatorcontrib>Angus, Derek C.</creatorcontrib><creatorcontrib>Watson, R. Scott</creatorcontrib><creatorcontrib>Wang, Chunyan</creatorcontrib><creatorcontrib>Callaway, Clifton W.</creatorcontrib><creatorcontrib>Bell, Michael J.</creatorcontrib><creatorcontrib>Kochanek, Patrick M.</creatorcontrib><creatorcontrib>Bluml, Stefan</creatorcontrib><creatorcontrib>Panigrahy, Ashok</creatorcontrib><title>Brain MR imaging and spectroscopy for outcome prognostication after pediatric cardiac arrest</title><title>Resuscitation</title><addtitle>Resuscitation</addtitle><description>Children surviving cardiac arrest are at high risk of neurological morbidity and mortality; however, there is a lack of validated prognostic biomarkers. We aimed to evaluate brain magnetic resonance imaging (MRI) and spectroscopy (MRS) as predictors of death and disability. Secondly, we evaluated whether MRI/S by randomized group. This single center study analyzed clinically indicated brain MRI/S data from children enrolled in a randomized controlled trial of 24 vs. 72 h of hypothermia following cardiac arrest. Two pediatric radiologists scored conventional MRIs. Lactate and N-acetyl-aspartate (NAA) concentrations (mmol/kg) were determined from spectra acquired from the basal ganglia, thalamus, parietal white matter and parietooccipital gray matter. Mortality and neurological outcomes (favorable = Pediatric Cerebral Performance Category [PCPC] 1, 2, 3 or increase &lt; 2) were assessed at hospital discharge. Non-parametric tests were used to test for associations between MRI/S biomarkers and outcome and randomized group. 23 children with (median [interquartile range]) age of 1.5 (0.3−4.0) years. Ten (44%) had favorable outcome. There were more T2 brain lesions in the lentiform nuclei in children with unfavorable 12 (92%) vs. favorable 3 (33%) outcome, p = 0.007. Increased lactate and decreased NAA concentrations in the parietooccipital gray matter and decreased NAA in the parietal white matter were associated with unfavorable outcome (p’s &lt; 0.05). There were no differences for any biomarker by randomized group. Regional cerebral and metabolic MRI/S biomarkers are predictive of neurological outcomes at hospital discharge in pediatric cardiac arrest and should undergo validation testing in a large sample.</description><subject>Cardiac arrest</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic resonance spectroscopy</subject><subject>Outcome</subject><subject>Pediatric</subject><subject>Prognostication</subject><issn>0300-9572</issn><issn>1873-1570</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNqNkVFrFDEUhYModlv9CxLwxZcZb5KdZIIgaGlVqBSKvgkhk9xZs-xOxiRT6L8369Zi33xKIOeee3I-Ql4zaBkw-XbbJsxLdqHYEuLUcuDQgmxBiCdkxXolGtYpeEpWIAAa3Sl-Qk5z3gKA6LR6Tk4El53oFFuRHx-TDRP9ekPD3m7CtKF28jTP6EqK2cX5jo4x0bgUF_dI5xQ3U8wluD-7qR0LJjqjD7ak4KizqV4dtalmLC_Is9HuMr68P8_I98uLb-efm6vrT1_OP1w1bq1ZadYSUQPvQWA_eOa8HRS3Gh3ndpB2dM53OEpUg4RBWI9s7LnnWmjuLR97cUbeH33nZdijdziVZHdmTvVP6c5EG8zjlyn8NJt4a5SSWsPB4M29QYq_lprc7EN2uNvZCeOSDV9z0TEpRFel745SV_vJCceHNQzMgY_Zmkd8zIGPAWkqnzr96t-kD7N_gVTBxVGAta_bgMlUI5xcbThVJsbH8F-LfgMDda4z</recordid><startdate>20201201</startdate><enddate>20201201</enddate><creator>Fink, Ericka L.</creator><creator>Wisnowski, Jessica</creator><creator>Clark, Robert</creator><creator>Berger, Rachel P.</creator><creator>Fabio, Anthony</creator><creator>Furtado, Andre</creator><creator>Narayan, Srikala</creator><creator>Angus, Derek C.</creator><creator>Watson, R. Scott</creator><creator>Wang, Chunyan</creator><creator>Callaway, Clifton W.</creator><creator>Bell, Michael J.</creator><creator>Kochanek, Patrick M.</creator><creator>Bluml, Stefan</creator><creator>Panigrahy, Ashok</creator><general>Elsevier B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-3683-4571</orcidid></search><sort><creationdate>20201201</creationdate><title>Brain MR imaging and spectroscopy for outcome prognostication after pediatric cardiac arrest</title><author>Fink, Ericka L. ; Wisnowski, Jessica ; Clark, Robert ; Berger, Rachel P. ; Fabio, Anthony ; Furtado, Andre ; Narayan, Srikala ; Angus, Derek C. ; Watson, R. Scott ; Wang, Chunyan ; Callaway, Clifton W. ; Bell, Michael J. ; Kochanek, Patrick M. ; Bluml, Stefan ; Panigrahy, Ashok</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c491t-46ee902803e8bd1cdab72a9ec22ab6afccd5ef6e7b60b3ade1f82d29392da2f83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Cardiac arrest</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic resonance spectroscopy</topic><topic>Outcome</topic><topic>Pediatric</topic><topic>Prognostication</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fink, Ericka L.</creatorcontrib><creatorcontrib>Wisnowski, Jessica</creatorcontrib><creatorcontrib>Clark, Robert</creatorcontrib><creatorcontrib>Berger, Rachel P.</creatorcontrib><creatorcontrib>Fabio, Anthony</creatorcontrib><creatorcontrib>Furtado, Andre</creatorcontrib><creatorcontrib>Narayan, Srikala</creatorcontrib><creatorcontrib>Angus, Derek C.</creatorcontrib><creatorcontrib>Watson, R. Scott</creatorcontrib><creatorcontrib>Wang, Chunyan</creatorcontrib><creatorcontrib>Callaway, Clifton W.</creatorcontrib><creatorcontrib>Bell, Michael J.</creatorcontrib><creatorcontrib>Kochanek, Patrick M.</creatorcontrib><creatorcontrib>Bluml, Stefan</creatorcontrib><creatorcontrib>Panigrahy, Ashok</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Resuscitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fink, Ericka L.</au><au>Wisnowski, Jessica</au><au>Clark, Robert</au><au>Berger, Rachel P.</au><au>Fabio, Anthony</au><au>Furtado, Andre</au><au>Narayan, Srikala</au><au>Angus, Derek C.</au><au>Watson, R. Scott</au><au>Wang, Chunyan</au><au>Callaway, Clifton W.</au><au>Bell, Michael J.</au><au>Kochanek, Patrick M.</au><au>Bluml, Stefan</au><au>Panigrahy, Ashok</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Brain MR imaging and spectroscopy for outcome prognostication after pediatric cardiac arrest</atitle><jtitle>Resuscitation</jtitle><addtitle>Resuscitation</addtitle><date>2020-12-01</date><risdate>2020</risdate><volume>157</volume><spage>185</spage><epage>194</epage><pages>185-194</pages><issn>0300-9572</issn><eissn>1873-1570</eissn><abstract>Children surviving cardiac arrest are at high risk of neurological morbidity and mortality; however, there is a lack of validated prognostic biomarkers. We aimed to evaluate brain magnetic resonance imaging (MRI) and spectroscopy (MRS) as predictors of death and disability. Secondly, we evaluated whether MRI/S by randomized group. This single center study analyzed clinically indicated brain MRI/S data from children enrolled in a randomized controlled trial of 24 vs. 72 h of hypothermia following cardiac arrest. Two pediatric radiologists scored conventional MRIs. Lactate and N-acetyl-aspartate (NAA) concentrations (mmol/kg) were determined from spectra acquired from the basal ganglia, thalamus, parietal white matter and parietooccipital gray matter. Mortality and neurological outcomes (favorable = Pediatric Cerebral Performance Category [PCPC] 1, 2, 3 or increase &lt; 2) were assessed at hospital discharge. Non-parametric tests were used to test for associations between MRI/S biomarkers and outcome and randomized group. 23 children with (median [interquartile range]) age of 1.5 (0.3−4.0) years. Ten (44%) had favorable outcome. There were more T2 brain lesions in the lentiform nuclei in children with unfavorable 12 (92%) vs. favorable 3 (33%) outcome, p = 0.007. Increased lactate and decreased NAA concentrations in the parietooccipital gray matter and decreased NAA in the parietal white matter were associated with unfavorable outcome (p’s &lt; 0.05). There were no differences for any biomarker by randomized group. Regional cerebral and metabolic MRI/S biomarkers are predictive of neurological outcomes at hospital discharge in pediatric cardiac arrest and should undergo validation testing in a large sample.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>32653571</pmid><doi>10.1016/j.resuscitation.2020.06.033</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-3683-4571</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0300-9572
ispartof Resuscitation, 2020-12, Vol.157, p.185-194
issn 0300-9572
1873-1570
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7769908
source Elsevier
subjects Cardiac arrest
Magnetic resonance imaging
Magnetic resonance spectroscopy
Outcome
Pediatric
Prognostication
title Brain MR imaging and spectroscopy for outcome prognostication after pediatric cardiac arrest
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-07T13%3A30%3A58IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Brain%20MR%20imaging%20and%20spectroscopy%20for%20outcome%20prognostication%20after%20pediatric%20cardiac%20arrest&rft.jtitle=Resuscitation&rft.au=Fink,%20Ericka%20L.&rft.date=2020-12-01&rft.volume=157&rft.spage=185&rft.epage=194&rft.pages=185-194&rft.issn=0300-9572&rft.eissn=1873-1570&rft_id=info:doi/10.1016/j.resuscitation.2020.06.033&rft_dat=%3Cproquest_pubme%3E2423516335%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c491t-46ee902803e8bd1cdab72a9ec22ab6afccd5ef6e7b60b3ade1f82d29392da2f83%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2423516335&rft_id=info:pmid/32653571&rfr_iscdi=true