Xu Jian, Rasmussen Inge-Andre, Lagopoulos Jim, Håberg Asta
Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
J Neurotrauma. 2007 May;24(5):753-65. doi: 10.1089/neu.2006.0208.
Traumatic brain injury (TBI) is the most common cause of death and disability in young people. The functional outcome in patients with TBI cannot be explained by focal pathology alone, and diffuse axonal injury (DAI) is considered a major contributor to the neurocognitive deficits experienced by this group. The aim of the present study was to investigate whether diffusion tensor imaging (DTI) offers additional information as to the extent of damage not visualized with standard magnetic resonance imaging (MRI) in patients with severe TBI. Nine chronic male TBI patients and 11 matched healthy controls were recruited. Results of the voxel-based analysis of fractional anisotropy (FA) maps and apparent diffusion coefficient (ADC) maps revealed significant differences in anisotropy in major white matter tracts, including the corpus callosum (CC), internal and external capsule, superior and inferior longitudinal fascicles, and the fornix in the TBI group. The FA and ADC measurements offered superior sensitivity compared to conventional MRI diagnosis of DAI. Region-of-interest (ROI) analyses confirmed these results in the investigated regions. The findings of this study support the hypothesis that severe TBI is accompanied by DAI. The DTI changes were more prominent on the right side that contained the focal pathology in most of the patients and accurately reflected differences in both hemispheres. In conclusion, DTI holds great promise as a diagnostic tool to identify and quantify the degree of white matter injury in TBI patients.
创伤性脑损伤(TBI)是年轻人死亡和残疾的最常见原因。TBI患者的功能预后不能仅由局灶性病理来解释,弥漫性轴索损伤(DAI)被认为是该组患者神经认知缺陷的主要原因。本研究的目的是调查弥散张量成像(DTI)是否能提供关于重度TBI患者中标准磁共振成像(MRI)未显示的损伤程度的额外信息。招募了9名慢性男性TBI患者和11名匹配的健康对照。基于体素的分数各向异性(FA)图和表观扩散系数(ADC)图分析结果显示,TBI组主要白质束的各向异性存在显著差异,包括胼胝体(CC)、内囊和外囊、上纵束和下纵束以及穹窿。与传统MRI诊断DAI相比,FA和ADC测量具有更高的敏感性。感兴趣区(ROI)分析在研究区域证实了这些结果。本研究结果支持重度TBI伴有DAI的假说。DTI变化在大多数患者中右侧更明显,右侧包含局灶性病变,并且准确反映了两侧半球的差异。总之,DTI作为一种诊断工具,在识别和量化TBI患者白质损伤程度方面具有很大的前景。