Purpose

The aim of this study was to predict neurological outcomes for acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) using diffusion-weighted imaging (DWI), and assess relationships between anatomical sites of lesions and their outcomes.

Materials and methods

We assessed DWI abnormalities and neurological outcomes in 30 patients with AESD, and classified patients into severe and non-severe groups according to their neurological outcomes. We also established a DWI scoring system as follows: zero for normal, and one for lesion at each location. Differences between the severe and non-severe groups were examined, and receiver operating characteristic (ROC) curve analysis was performed.

Results

Nine (30%) patients were classified into the severe group. On DWI, patients in the severe group were more likely to have temporal lobe (P = 0.014), perirolandic (P = 0.008), and corpus callosum (P = 0.0008) lesions than those in the non-severe group. The total DWI scores were significantly higher in the severe group than those in the non-severe group (P = 0.0002). ROC curve showed an area under the curve of 0.929, with a cutoff value of five, sensitivity of 88.9%, and specificity of 81.0%.

Conclusion

Patients with severe AESD had more extensive DWI abnormalities than those with non-severe AESD. Our DWI scoring system may be useful for the prediction of outcomes of AESD. Widespread lesions seemed to have stronger influence on outcomes than each lesion location.

中文翻译：

---

DWI 评分系统用于急性脑病双相发作和晚期弥散减少的预后。

目的

本研究的目的是使用弥散加权成像 (DWI) 预测伴有双相癫痫发作和迟发弥散 (AESD) 的急性脑病的神经学结果，并评估病变解剖部位与其结果之间的关系。

材料和方法

我们评估了 30 名 AESD 患者的 DWI 异常和神经系统结果，并根据他们的神经系统结果将患者分为严重组和非严重组。我们还建立了如下的 DWI 评分系统：正常为 0，病变为 1。检查了严重组和非严重组之间的差异，并进行了受试者工作特征 (ROC) 曲线分析。

结果

九名 (30%) 患者被归类为严重组。在 DWI 上，重度组患者比非重度组患者更可能出现颞叶 ( P  = 0.014)、perirolandic ( P  = 0.008) 和胼胝体 ( P  = 0.0008) 病变。重症组 DWI 总分明显高于非重症组（P  =0.0002）。ROC曲线显示曲线下面积为0.929，截断值为5，敏感性为88.9%，特异性为81.0%。

结论

与非严重 AESD 患者相比，严重 AESD 患者具有更广泛的 DWI 异常。我们的 DWI 评分系统可能有助于预测 AESD 的结果。与每个病变位置相比，广泛的病变似乎对结果的影响更大。