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DWI scoring system for prognosis of acute encephalopathy with biphasic seizures and late reduced diffusion

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Abstract

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.

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Acknowledgements

We thank Dr. Megumi Nukui, Dr. Takeshi Inoue, Dr. Shin Okazaki, and Dr. Hisashi Kawawaki (Department of Pediatric Neurology, Osaka City General Hospital), Dr. Junichi Ishikawa and Dr. Hiroshi Rinka (Emergency and Critical Care Center, Osaka City General Hospital), and Dr. Masashi Shiomi (Department of Pediatrics, Aizenbashi Hospital), for their support.

Funding

This research did not receive any specific grants from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Departments of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka City University, 1-4-3 Asahi-cho, Abeno-ku, Osaka, Japan

    Hirotaka Takita, Taro Shimono & Yukio Miki

  2. Department of Diagnostic Radiology, Osaka City General Hospital, Osaka, Japan

    Hirotaka Takita & Takao Manabe

  3. Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan

    Ichiro Kuki

  4. Department of Pediatric Emergency Medicine, Osaka City General Hospital, Osaka, Japan

    Kiyoko Amo & Masao Togawa

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  1. Hirotaka Takita
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  2. Taro Shimono
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Correspondence to Hirotaka Takita.

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Takita, H., Shimono, T., Manabe, T. et al. DWI scoring system for prognosis of acute encephalopathy with biphasic seizures and late reduced diffusion. Jpn J Radiol 38, 860–869 (2020). https://doi.org/10.1007/s11604-020-00984-8

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  • DOI: https://doi.org/10.1007/s11604-020-00984-8

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