Quantitative parameters and imaging signs of MMRI-DWI in predicting short-term prognosis of senile cerebral hemor-rhage

FU Heng; XU Liling; LI Shuang

Abstract：Objective To investigate the value of magnetic resonance imaging(MRI)-diffusion weighted imaging(DWI)quantitative parameters and imaging signs in predicting the short-term prognosis of acute intracerebral hemorrhage(AICH)in el-derly patients.Methods A total of 102 elderly patients with AICH were selected in this work.Quantitative parameters[appar-ent diffusion coefficient(ADC)]and imaging signs were obtained by MMRI DWI examination upon admission.ADC and imaging signs of patients with different intracerebral hemorrhage characteristics(bleeding site,bleeding amount,and severity of disease)were compared.The correlation between ADC and cerebral hemorrhage was analyzed.The improved Rankin Scale(mRS)was used to evaluate the prognosis of patients 3 months after discharge.Clinical data and ADC of patients with good prognosis and poor prognosis were compared.The influencing factors of poor prognosis of elderly AICH patients were analyzed,and the value of ADC and its influencing factors in predicting poor prognosis of elderly AICH patients were analyzed.We compared the prediction performance of prediction schemes with and without ADC.Results 1)There were significant differences in ADC among elderly AICH patients with different blood loss and disease degree(P<0.05).2)ADC was negatively correlated with blood loss and dis-ease severity(P<0.05).3)The incidence of blood loss,preoperative NIHSS score,hemorrhage into ventricle,early neurological deterioration,postoperative pulmonary infection and stress ulcer in patients with poor prognosis was higher than that in patients with good prognosis,and the incidence of preoperative ADC was lower than that in patients with good prognosis(P<0.05).4)Preoperative ADC,bleeding into the ventricle,early neurological deterioration,postoperative pulmonary infection and stress ul-cer were independent factors of poor prognosis in elderly patients with AICH(P<0.05).5)The area under the curve(AUC)of preoperative ADC,bleeding into the ventricle,early neurological deterioration,postoperative pulmonary infection,and stress ul-cer predicted poor prognosis in elderly patients with AICH were 0.813,0.681,0.632,0.638,0.627,respectively.6)Prediction protocols including ADC(preoperative ADC,hemorrhage into the ventricle,early neurological deterioration,postoperative pul-monary infection,stress ulcer combined)predicted poor prognosis with an AUC of 0.932(95%CI:0.865～0.972),the predic-tion sensitivity was 97.37%,and the specificity was 78.12%.Compared with the prediction scheme without ADC(hemorrhage into the ventricle,early neurological deterioration,postoperative pulmonary infection,stress ulcer combination),the AUC of the prediction scheme with ADC was significantly increased(P<0.05).Conclusion MRI-DWI quantitative parameter ADC has certain value in the short-term prognosis of patients with AICH,especially,the combination of prognostic factors can im-prove the prediction efficiency.