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Diffusion-weighted magnetic resonance imaging lesions after repair of acute type A aortic dissection: association with neurocognitive outcomes

Authors
 Suk-Won Song  ;  Kyung-Jong Yoo  ;  Yoo Rim Shin  ;  Sun-Hee Lim  ;  Bum-Koo Cho 
Citation
 EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, Vol.47(2) : 367-373, 2015 
Journal Title
 EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY 
ISSN
 1010-7940 
Issue Date
2015
MeSH
Adult ; Aged ; Aneurysm, Dissecting/complications ; Aneurysm, Dissecting/pathology* ; Aortic Aneurysm/complications ; Aortic Aneurysm/pathology* ; Brain/blood supply* ; Cognition Disorders/blood* ; Cognition Disorders/etiology ; Cognition Disorders/physiopathology ; Cohort Studies ; Female ; Humans ; Magnetic Resonance Imaging/methods* ; Male ; Middle Aged ; Oxygen/analysis* ; Treatment Outcome
Keywords
Aortic dissection ; Neurocognitive dysfunction
Abstract
OBJECTIVES: We sought to analyse the preoperative status of arch vessels by postoperative diffusion-weighted magnetic resonance imaging (DWI) as a potential surrogate marker for cerebral thromboembolism and its relationship to neurocognitive outcomes. METHODS: Preoperative computed tomography (CT) and postoperative DWI were available for 50 patients who received surgery for acute type A aortic dissection. Two radiologists evaluated CT and DWI scans. Mini-mental status examinations (MMSE) were performed on the same day with DWI. RESULTS: Mean age of participants was 57 ± 14 years. MMSE and DWI were performed 6 ± 3 days after surgery. New cerebral embolisms were evident in 35 of 50 patients (70%) and often occurred as multiple lesions (28/35, 80%; range 2-21). Among patients with multiple lesions, 23 (66%) were clinically silent. Pathological lesions at the origin of the arch vessels correlated with the number and volume of new DWI lesions (P < 0.05). Degree of neurocognitive dysfunction tested by MMSE was negatively associated with age (r = -0.48, P < 0.0001) and left-sided DWI lesion number and volume (r = -0.74, P < 0.0001; r = -0.707, P < 0.0001). CONCLUSIONS: DWI revealed new cerebral embolisms in 70% of patients following surgery for acute type A aortic dissection. Lesion number and volume significantly correlated with pathological status of arch vessels. MMSE was representative of left-sided lesions.
Full Text
http://ejcts.oxfordjournals.org/content/47/2/367.long
DOI
10.1093/ejcts/ezu169
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Song, Suk Won(송석원) ORCID logo https://orcid.org/0000-0002-9850-9707
Shin, Yu Rim(신유림)
Yoo, Kyung Jong(유경종) ORCID logo https://orcid.org/0000-0002-9858-140X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/139249
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