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Evaluation of brain lesions in patients after coronary artery bypass grafting using MRI with the emphasis on susceptibility-weighted imaging.

Michałowska I, Furmanek MI, Smaga E, Juraszyński Z, Zieliński T, Chełstowska S, Kuśmierczyk M, Szpakowski E, Mierzyńska A, Walecki JM - Kardiochir Torakochirurgia Pol (2015)

Bottom Line: Hemorrhagic stroke was observed in 1 patient.In all patients (except for 1 with stroke), lesions visible in MRI were clinically silent.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Institute of Cardiology, Warsaw, Poland.

ABSTRACT

Introduction: Patients undergoing coronary artery bypass grafting (CABG) are at risk of strokes and neurocognitive disorders.

The aim of the study: The aim of the study was to assess the clinical utility of susceptibility-weighted imaging (SWI) MRI in detection of new brain lesions in patients after CABG. We assessed the incidence and types of brain lesions and correlated the data with neurological examinations in groups of patients who underwent on-pump and off-pump CABG.

Material and methods: Patients underwent a neurological examination and MRI before, 6-20 days after and 6 months after the CABG. Fifty-one patients (43 men, mean age 63.12 years) were analyzed.

Results: Fifteen (29.4%) patients underwent on-pump CABG, 36 (70.6%) off-pump CABG. On postoperative scans new lesions were detected in 12 (23.5%) patients. Ischemic lesions (visible on diffusion-weighted imaging [DWI]) were detected in 4 patients, in 6 lesions were visible on SWI, in 1 case lesions were visible on SWI and DWI. Hemorrhagic stroke was observed in 1 patient. In the group of patients who underwent on-pump CABG, new brain lesions were observed in 60.0% of patients vs. 8.3% of those who underwent off-pump CABG (p < 0.0001); these changes more frequently were multiple (p < 0.0013) and located infratentorially (p < 0.0218). Lesions visible on SWI were observed only in patients undergoing on-pump CABG (p = 0.00005). In all patients (except for 1 with stroke), lesions visible in MRI were clinically silent.

Conclusions: The use of SWI enables one to detect lesions occurring in the brain after CABG, invisible in other sequences. On-pump CABG is associated with a greater risk of clinically silent brain damage compared to off-pump CABG.

No MeSH data available.


Related in: MedlinePlus

Graph shows the comparison of brain changes detected by MRI on SWI (susceptibility-weighted imaging) and DWI (diffusionweighted imaging) among patients who underwent on-pump and off- pump coronary artery bypass grafting
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Figure 0004: Graph shows the comparison of brain changes detected by MRI on SWI (susceptibility-weighted imaging) and DWI (diffusionweighted imaging) among patients who underwent on-pump and off- pump coronary artery bypass grafting

Mentions: There were no significant differences between the patients who underwent on-pump and off-pump CABG in their age or sex distribution, cerebrovascular history, carotid artery stenosis or history of hypertension or diabetes, or in their preoperative MMSE scores, neurological examinations results (mRankin and NIHSS) or MRI abnormalities (lacunar infarcts, leukoaraiosis or previous cortical infarcts). There was a significant difference in prevalence, character and the number of new lesions detected on MRI examination between patients operated on-pump and off-pump (Fig. 4 shows types of new lesions in both groups of patients). In the group of patients who underwent on-pump CABG, changes were observed in 60.0% (9/15) of patients vs. 8.3% (3/36) who underwent off-pump CABG (p < 0.0001); these changes more often were multiple (p < 0.0013) and located infratentorially (p < 0.0218).


Evaluation of brain lesions in patients after coronary artery bypass grafting using MRI with the emphasis on susceptibility-weighted imaging.

Michałowska I, Furmanek MI, Smaga E, Juraszyński Z, Zieliński T, Chełstowska S, Kuśmierczyk M, Szpakowski E, Mierzyńska A, Walecki JM - Kardiochir Torakochirurgia Pol (2015)

Graph shows the comparison of brain changes detected by MRI on SWI (susceptibility-weighted imaging) and DWI (diffusionweighted imaging) among patients who underwent on-pump and off- pump coronary artery bypass grafting
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4520514&req=5

Figure 0004: Graph shows the comparison of brain changes detected by MRI on SWI (susceptibility-weighted imaging) and DWI (diffusionweighted imaging) among patients who underwent on-pump and off- pump coronary artery bypass grafting
Mentions: There were no significant differences between the patients who underwent on-pump and off-pump CABG in their age or sex distribution, cerebrovascular history, carotid artery stenosis or history of hypertension or diabetes, or in their preoperative MMSE scores, neurological examinations results (mRankin and NIHSS) or MRI abnormalities (lacunar infarcts, leukoaraiosis or previous cortical infarcts). There was a significant difference in prevalence, character and the number of new lesions detected on MRI examination between patients operated on-pump and off-pump (Fig. 4 shows types of new lesions in both groups of patients). In the group of patients who underwent on-pump CABG, changes were observed in 60.0% (9/15) of patients vs. 8.3% (3/36) who underwent off-pump CABG (p < 0.0001); these changes more often were multiple (p < 0.0013) and located infratentorially (p < 0.0218).

Bottom Line: Hemorrhagic stroke was observed in 1 patient.In all patients (except for 1 with stroke), lesions visible in MRI were clinically silent.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Institute of Cardiology, Warsaw, Poland.

ABSTRACT

Introduction: Patients undergoing coronary artery bypass grafting (CABG) are at risk of strokes and neurocognitive disorders.

The aim of the study: The aim of the study was to assess the clinical utility of susceptibility-weighted imaging (SWI) MRI in detection of new brain lesions in patients after CABG. We assessed the incidence and types of brain lesions and correlated the data with neurological examinations in groups of patients who underwent on-pump and off-pump CABG.

Material and methods: Patients underwent a neurological examination and MRI before, 6-20 days after and 6 months after the CABG. Fifty-one patients (43 men, mean age 63.12 years) were analyzed.

Results: Fifteen (29.4%) patients underwent on-pump CABG, 36 (70.6%) off-pump CABG. On postoperative scans new lesions were detected in 12 (23.5%) patients. Ischemic lesions (visible on diffusion-weighted imaging [DWI]) were detected in 4 patients, in 6 lesions were visible on SWI, in 1 case lesions were visible on SWI and DWI. Hemorrhagic stroke was observed in 1 patient. In the group of patients who underwent on-pump CABG, new brain lesions were observed in 60.0% of patients vs. 8.3% of those who underwent off-pump CABG (p < 0.0001); these changes more frequently were multiple (p < 0.0013) and located infratentorially (p < 0.0218). Lesions visible on SWI were observed only in patients undergoing on-pump CABG (p = 0.00005). In all patients (except for 1 with stroke), lesions visible in MRI were clinically silent.

Conclusions: The use of SWI enables one to detect lesions occurring in the brain after CABG, invisible in other sequences. On-pump CABG is associated with a greater risk of clinically silent brain damage compared to off-pump CABG.

No MeSH data available.


Related in: MedlinePlus