Diagnostics (Aug 2024)

Prognostic Implication of Ventricular Volumetry in Early Brain Computed Tomography after Cardiac Arrest

  • Ae Kyung Gong,
  • Sang Hoon Oh,
  • Jinhee Jang,
  • Kyu Nam Park,
  • Han Joon Kim,
  • Ji Young Lee,
  • Chun Song Youn,
  • Jee Yong Lim,
  • Hyo Joon Kim,
  • Hyo Jin Bang

DOI
https://doi.org/10.3390/diagnostics14161701
Journal volume & issue
Vol. 14, no. 16
p. 1701

Abstract

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Brain swelling after cardiac arrest may affect brain ventricular volume. This study aimed to investigate the prognostic implications of ventricular volume on early thin-slice brain computed tomography (CT) after cardiac arrest. We measured the gray-to-white matter ratio (GWR) and the characteristics and volumes of the lateral, third, and fourth ventricles. The primary outcome was a poor 6-month neurological outcome. Of the 166 patients, 115 had a poor outcome. The fourth ventricle was significantly smaller in the poor outcome group (0.58 cm3 [95% CI, 0.43–0.80]) than in the good outcome group (0.74 cm3 [95% CI, 0.68–0.99], p 3) predicted poor outcomes with 100% specificity and sensitivities of 8.7% (95% CI, 4.2–15.4) and 20.9% (95% CI, 13.9–29.4), respectively. Combining these measures improved the sensitivity to 25.2% (95% CI, 17.6–34.2). After adjusting for covariates, the fourth ventricular volume was independently associated with neurologic outcome. A marked decrease in fourth ventricular volume, with concomitant hypoattenuation on CT scans, more accurately predicted outcomes.

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