Kumar Raj, Gupta Rakesh K, Husain Mazhar, Chaudhry Chaynika, Srivastava Arti, Saksena Sona, Rathore Ram K S
Department of Neurosurgery, Chhatrapati Shahuji Maharaj Medical University, Lucknow, UP, India.
Brain Inj. 2009 Jul;23(7):675-85. doi: 10.1080/02699050903014915.
To look for differences in vulnerability of corpus callosum (CC) in patients of mild and moderate traumatic brain injury (TBI) in the acute stage using quantitative diffusion tensor imaging (DTI) and to correlate these with neuropsychometric tests (NPT) done at 6 months post-injury. RESEARCH DESIGN, METHODS AND PROCEDURES: Conventional MRI, DTI and NPT were performed on 83 patients (moderate TBI, n = 57; mild TBI, n = 26) within 5-14 days after TBI. Thirty-three age- and sex-matched healthy controls were also included for comparison.
Significantly decreased fractional anisotropy (FA) in genu and splenium; significantly increased radial diffusivity (RD) values in genu, midbody and splenium with significant increase in mean diffusivity (MD) and a decrease in axial diffusivity (AD) only in genu, respectively, in patients with moderate TBI compared to healthy controls were observed. However, in moderate TBI, significantly decreased FA was found only in genu compared to mild TBI. Moderate TBI showed poor NPT scores compared to mild TBI, but this did not reach statistical significance.
It is concluded that DTI abnormalities in the regions of CC were more in patients with moderate TBI compared to mild TBI and this was associated with relatively poor neuropsychological outcome 6 months post-injury.
使用定量扩散张量成像（DTI）寻找轻度和中度创伤性脑损伤（TBI）患者急性期胼胝体（CC）易损性的差异，并将这些差异与伤后6个月进行的神经心理测试（NPT）结果相关联。研究设计、方法与步骤：对83例患者（中度TBI，n = 57；轻度TBI，n = 26）在TBI后5 - 14天内进行了常规MRI、DTI和NPT检查。还纳入了33名年龄和性别匹配的健康对照者进行比较。
与健康对照者相比，中度TBI患者的胼胝体膝部和压部的各向异性分数（FA）显著降低；胼胝体膝部、体部和压部的径向扩散率（RD）值显著升高，仅胼胝体膝部的平均扩散率（MD）显著升高且轴向扩散率（AD）降低。然而，与轻度TBI相比，中度TBI仅在胼胝体膝部发现FA显著降低。与轻度TBI相比，中度TBI的NPT评分较差，但未达到统计学意义。
得出结论，与轻度TBI相比，中度TBI患者胼胝体区域的DTI异常更多，且这与伤后6个月相对较差的神经心理学结果相关。
