Cardiac arrest & resuscitation
Utility of magnetic resonance spectroscopy in predicting favorable outcome in adult comatose patients following cardiac arrest
Authors' conclusion
MRS-derived NAA/Cr in the PCG is a valuable predictor of good outcome in comatose CA patients, outperforming quantitative ADC measurements for coma recovery.
Study context
- Population
- Comatose adult patients after cardiac arrest who underwent MRI and concurrent magnetic resonance spectroscopy (MRS)
- Participants
- 94 patients
- Comparison
- Coma recovery vs No coma recovery
- Coma recoveryn = 25
- Outcome
- Coma recovery
- Follow-up
- Hospital discharge
Performance
As reported in the abstract
NAA/Cr in the PCG, coma recovery
Coma recovery
1.29
median · IQR 0.21
No coma recovery
0.86
median · IQR 0.32
P < 0.0001
- AUC of NAA/Cr for coma recovery
- 0.9 (95 % CI 0.84-0.96)
Secondary outcomes
Good neurological function (CPC 1-2) · 6 months
- Good outcome
- 22 (23 %)
- AUROC of NAA/Cr for good outcome
- 0.88 (95 % CI 0.82-0.95)
- Not significantly better than mean apparent diffusion coefficient (ADC) of the posterior cingulate gyrus (PCG)
- adj. p-value = 0.064
Multivariable models with NAA/Cr or ADC plus clinical and EEG variables
- Improved performance vs clinical and EEG variables alone, difference not statistically significant
Adding MRS to established early predictors of favorable outcome
- Specificity at 100 % sensitivity, from 67 % to
- 93 %
Original publication
Utility of magnetic resonance spectroscopy in predicting favorable outcome in adult comatose patients following cardiac arrest. Resuscitation. Published 27 June 2025. doi:10.
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