@article{ref1,
title="Assessment of white matter injury and outcome in severe brain trauma: a prospective multicenter cohort",
journal="Anesthesiology",
year="2012",
author="de Champfleur, Nicolas Menjot and Tollard, Eléonore and Sanchez, Paola and Stevens, Robert D. and Gupta, Rajiv and Perlbarg, Vincent and Galanaud, Damien and Dinkel, Julien and Faivre, Sébastien and Soto-Ares, Gustavo and Veber, Benoit and Cottenceau, Vincent and Masson, Françoise and Tourdias, Thomas and André, Edith and Audibert, Gérard and Schmitt, Emmanuelle and Ibarrola, Danielle and Dailler, Frédéric and Vanhaudenhuyse, Audrey and Tshibanda, Luaba and Payen, Jean-François and Le Bas, Jean-François and Krainik, Alexandre and Bruder, Nicolas and Girard, Nadine and Laureys, Steven and Benali, Habib and Puybasset, Louis",
volume="117",
number="6",
pages="1300-1310",
abstract="BACKGROUND:: Existing methods to predict recovery after severe traumatic brain injury lack accuracy. The aim of this study is to determine the prognostic value of quantitative diffusion tensor imaging (DTI). METHODS:: In a multicenter study, the authors prospectively enrolled 105 patients who remained comatose at least 7 days after traumatic brain injury. Patients underwent brain magnetic resonance imaging, including DTI in 20 preselected white matter tracts. Patients were evaluated at 1 yr with a modified Glasgow Outcome Scale. A composite DTI score was constructed for outcome prognostication on this training database and then validated on an independent database (n = 38). DTI score was compared with the International Mission for Prognosis and Analysis of Clinical Trials Score. RESULTS:: Using the DTI score for prediction of unfavorable outcome on the training database, the area under the receiver operating characteristic curve was 0.84 (95% CI: 0.75-0.91). The DTI score had a sensitivity of 64% and a specificity of 95% for the prediction of unfavorable outcome. On the validation-independent database, the area under the receiver operating characteristic curve was 0.80 (95% CI: 0.54-0.94). On the training database, reclassification methods showed significant improvement of classification accuracy (P < 0.05) compared with the International Mission for Prognosis and Analysis of Clinical Trials score. Similar results were observed on the validation database. CONCLUSIONS:: White matter assessment with quantitative DTI increases the accuracy of long-term outcome prediction compared with the available clinical/radiographic prognostic score.<p /> <p>Language: en</p>",
language="en",
issn="0003-3022",
doi="10.1097/ALN.0b013e3182755558",
url="http://dx.doi.org/10.1097/ALN.0b013e3182755558"
}