Acute cardiac care & resuscitation
Time-resolved apparent diffusion coefficient (ADC) analysis differentiates stable vs. progressive brain injury in post–cardiac arrest patients
Authors' conclusion
Serial ADC analysis reveals dynamic and diverging HIBI patterns in OHCA survivors. Subacute MRI more accurately reflects progressive HIBI and improves prognostic performance
Study context
- Population
- Adult comatose out-of-hospital cardiac arrest (OHCA) survivors with brain MRI within 6 h and at 72–96 h post-ROSC
- Participants
- 122 survivors
- Exposure
- Subacute vs ultra-early MRI ADC analysis
- Poor outcomen = 61
- Outcome
- Poor outcome (CPC 3-5)
- Follow-up
- 6 months
Main finding
As reported in the abstract
Prognostic accuracy of ADC metrics for poor outcome
Subacute MRI showed stronger group separation and higher prognostic accuracy than ultra-early MRI; AUC peak for ADC-R(400)
0.91
Sensitivity improvement at ADC-R(420)
+0.53
Observational data: associations, not effects.
Further findings
ADC distribution by outcome
- Poor outcome: progressive accumulation of low-ADC voxels (irreversible injury), × 10-6 mm²/s
- 280-600
- Good outcome: rightward shift in ADC distributions, increased mid-to-high range ADC values (partial diffusion normalisation)
Correlation of ADC-R(x) with serum neuron-specific enolase (NSE)
- Poor outcome group at 6 h, ρ
- 0.65
- Overall cohort at 72-96 h, ρ
- 0.50
Original publication
Time-resolved ADC analysis differentiates stable vs. progressive brain injury in post–cardiac arrest patients. Resuscitation. Published 24 September 2025. doi:10.
Summarised from the published abstract; every number is checked against it