Ng Kevin, Mikulis David J, Glazer Joanna, Kabani Noor, Till Christine, Greenberg Gahl, Thompson Andrew, Lazinski Dorothy, Agid Ronit, Colella Brenda, Green Robin E
Department of Medical Imaging, Division of Neuroradiology, University Health Network, University of Toronto.
Arch Phys Med Rehabil. 2008 Dec;89(12 Suppl):S35-44. doi: 10.1016/j.apmr.2008.07.006.
To demonstrate subacute progression of brain atrophy (from 4.5-29mo postinjury) in moderate to severe traumatic brain injury (TBI) using structural magnetic resonance imaging (MRI).
Within-subjects, repeated-measures design.
Inpatient neurorehabilitation program and teaching hospital (MRI department).
Adults (N=14) with moderate to severe TBI.
Not applicable.
Neuroradiologist readings and volumetric measurements (total brain cerebrospinal fluid and hippocampus) at 4.5 months and 2.5 years postinjury.
Ten of 14 patients showed visible atrophy progression. Significant increase in cerebrospinal fluid (CSF) volume (t(13)=-4.073, P<.001) and decrease in right and left hippocampal volumes (t(13)=4.221, P<.001 and t(13)=3.078, P<.005, respectively) were observed from 4.5 months to 2.5 years. Compared with published normative data, patients with TBI showed significantly more pathologic percent annual volume change for the hippocampi (t(26)=-3.864, P<.001, right; and t(26)=-2.737, P<.01, left), and a trend for CSF (t(26)=1.655, P=.059).
This study provides strong MRI evidence for subacute progression of atrophy, as distinct from early, acute neurologic changes observed.
利用结构磁共振成像（MRI）来证明中度至重度创伤性脑损伤（TBI）后脑萎缩的亚急性进展（伤后4.5 - 29个月）。
受试者内重复测量设计。
住院神经康复项目及教学医院（MRI科室）。
中度至重度TBI的成年人（N = 14）。
不适用。
伤后4.5个月和2.5年时神经放射科医生的读片结果及体积测量（全脑脑脊液和海马体）。
14例患者中有10例显示出明显的萎缩进展。从4.5个月到2.5年，观察到脑脊液（CSF）体积显著增加（t(13)= -4.073，P <.001），右侧和左侧海马体体积减小（分别为t(13)= 4.221，P <.001和t(13)= 3.078，P <.005）。与已发表的正常数据相比，TBI患者海马体的年病理性体积变化百分比显著更高（右侧t(26)= -3.864，P <.001；左侧t(26)= -2.737，P <.01），脑脊液有变化趋势（t(26)= 1.655，P =.059）。
本研究为萎缩的亚急性进展提供了有力的MRI证据，这与早期观察到的急性神经学变化不同。
