Cardiac arrest & resuscitation
Etiology-specific prognostic value of ultra-early diffusion-weighted MRI after out-of-hospital cardiac arrest: a multicenter cohort study
Authors' conclusion
HSI on ultra-early DW-MRI is specific for poor outcome after OHCA, but sensitivity is lower in respiratory etiology. DW-MRI at 72-96 h provides prognostic performance independent of etiology.
Study context
- Population
- Out-of-hospital cardiac arrest (OHCA) survivors who underwent ultra-early diffusion-weighted magnetic resonance imaging (DW-MRI) (0–6 h after ROSC)94 (53.4%) poor outcomes
- Participants
- 176 survivors
- Exposure
- Cardiac vs respiratory etiology; ultra-early DW-MRI high-signal-intensity (HSI) and ADC-R
- Cardiacn = 77
- Respiratoryn = 99
- Outcome
- Poor neurological outcome (CPC 3-5)
- Follow-up
- 6 months
Methodological detailsmulticentre, blinded readers
- Multicentre
- Blinded readers
Main finding
As reported in the abstract
Prognostic performance of ultra-early DW-MRI for poor outcome
| Group | HSI AUC | ADC-R(650) AUC | HSI sensitivity at 100% specificity |
|---|---|---|---|
| Cardiac | 0.93 | 0.80 | 86% |
| Respiratory | 0.76 | 0.77 | 52% |
HSI AUC
Cardiac0.93
Respiratory0.76
ADC-R(650) AUC
Cardiac0.80
Respiratory0.77
HSI sensitivity at 100% specificity
Cardiac86%
Respiratory52%
- Respiratory vs Cardiac: P = 0.006
- Cardiac vs Respiratory: P < 0.001
- Cardiac vs Respiratory: P = 0.71
- Ultra-early HSI occurred only in poor outcomes: specificity in both etiologies
- 100%
- Ultra-early HSI AUC, overall
- 0.80
- Ultra-early ADC-R(650) AUC, overall
- 0.77
Observational data: associations, not effects.
Further findings
| Outcome | Cardiac | Respiratory | P value |
|---|---|---|---|
| Follow-up DW-MRI (72-96 h) prognostic performance | P = 0.57 | ||
| HSI AUC | 0.96 | 0.95 | |
| ADC-R(650) AUC | 0.89 | 0.93 | |
| Follow-up DW-MRI (72-96 h) prognostic performance | P = 0.47 |
- Follow-up DW-MRI (72-96 h) prognostic performance — HSI AUC, overall
- 0.93
- Follow-up DW-MRI (72-96 h) prognostic performance — ADC-R(650) AUC, overall
- 0.91
- Follow-up DW-MRI (72-96 h) prognostic performance: follow-up subset n = 150
Original publication
Etiology-specific prognostic value of ultra-early diffusion-weighted MRI after out-of-hospital cardiac arrest: a multicenter cohort study. Crit Care. Published 6 March 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →