naa a22 4500 510799515 CHVBK 20180411083348.0 cr unu---uuuuu 180411e20131201xx s 000 0 eng 10.1007/s12028-013-9886-2 doi (NATIONALLICENCE)springer-10.1007/s12028-013-9886-2 Prediction of Poor Outcome in Cerebellar Infarction by Diffusion MRI [Elektronische Daten] [Zahari Tchopev, Marc Hiller, Jiachen Zhuo, Joshua Betz, Rao Gullapalli, Kevin Sheth] Objective: Identification of patients with posterior fossa infarction at risk for neurological deterioration remains a challenge. MRI-based assessments of MCA infarction can predict poor outcome. Similar quantitative imaging measures after cerebellar stroke have not been studied. We tested the hypothesis that MRI-based volumetric assessment of cerebellar infarcts can provide reliable information for the prediction of poor outcome. Design: We retrospectively identified 44 consecutive subjects (age 55.2±13) with cerebellar stroke who underwent MRI with diffusion-weighted imaging (DWI) (median 63.7h). Subjects were divided into poor (n=13) and good outcomes (n=31). Poor outcome was defined as having at least one of the following criteria: (1) mortality, (2) decompressive craniectomy, (3) ventriculostomy, and (4) decrease level of consciousness. DWI and cerebellar volume were defined on apparent diffusion coefficient maps. The ratio of the lesion volume to the whole cerebellum volume was calculated (rVolume). Measurements and Main Results: Logistic regression revealed that lesion volume and rVolume were associated with increased risk of poor outcome, even after adjusting for age and NIHSS (χ 2=8.2230, p<0.0042; χ 2=8.3992, p<0.0038, respectively). The receiver operating characteristic curve with age, NIHSS, and volume or rVolume achieved an AUC of 0.816 (95% CI 0.678-0.955) and 0.831 (95% CI 0.6989-0.9636), respectively. Conclusions: Quantitative volumetric measurement predicts poor outcome of cerebellar stroke patients, even when controlling for age and NIHSS. Quantitative analysis of diffusion MRI may assist in identification of patients with cerebellar stroke at highest risk of neurological deterioration. Prospective validation is warranted. Springer Science+Business Media New York, 2013 Stroke nationallicence Cerebellum nationallicence Magnetic resonance imaging nationallicence Outcome assessment nationallicence Stroke volume nationallicence Tchopev Zahari University of Maryland College Park, College Park, MD, USA aut Hiller Marc University of Maryland School of Medicine, Baltimore, MD, USA aut Zhuo Jiachen Magnetic Resonance Research Center, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA aut Betz Joshua Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA aut Gullapalli Rao Magnetic Resonance Research Center, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA aut Sheth Kevin Division of Neuro-Critical Care & Emergency Neurology, Yale University School of Medicine, 628 S. Wolfe Street, 21231, Baltimore, MD, USA aut Neurocritical Care Springer US; http://www.springer-ny.com 19/3(2013-12-01), 276-282 1541-6933 19:3<276 2013 19 12028 https://doi.org/10.1007/s12028-013-9886-2 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-013-9886-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Tchopev Zahari University of Maryland College Park, College Park, MD, USA aut NATIONALLICENCE 700 1- Hiller Marc University of Maryland School of Medicine, Baltimore, MD, USA aut NATIONALLICENCE 700 1- Zhuo Jiachen Magnetic Resonance Research Center, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA aut NATIONALLICENCE 700 1- Betz Joshua Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA aut NATIONALLICENCE 700 1- Gullapalli Rao Magnetic Resonance Research Center, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA aut NATIONALLICENCE 700 1- Sheth Kevin Division of Neuro-Critical Care & Emergency Neurology, Yale University School of Medicine, 628 S. Wolfe Street, 21231, Baltimore, MD, USA aut NATIONALLICENCE 773 0- Neurocritical Care Springer US; http://www.springer-ny.com 19/3(2013-12-01), 276-282 1541-6933 19:3<276 2013 19 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer