E B Singleton Department of Diagnostic Imaging, Texas Children's Hospital, Houston, TX 77030, USA.
AJNR Am J Neuroradiol. 2010 Feb;31(2):340-6. doi: 10.3174/ajnr.A1806. Epub 2009 Dec 3.
DTI of normal-appearing WM as evaluated by conventional MR imaging in mTBI has the potential to identify important regional abnormalities that relate to PCS. VBA was used to examine WM changes in acute mTBI.
WM was assessed between 1 and 6 days postinjury with voxel-based DTI analyses in 10 adolescent patients with mTBI and 10 age-matched control participants. In addition to the voxel-based group, analysis used to identify brain pathology across all patients with mTBI, 2 voxel-based linear regressions were performed. These analyses investigated the relation between 1) the ADC and PCS severity scores, and 2) ADC and scores on the BSI of emotional symptoms associated with mTBI. We hypothesized that frontotemporal WM changes would relate to symptoms associated with PCS and endorsed on the BSI.
Patients with mTBI demonstrated significant reductions in ADC in several WM regions and in the left thalamus. As expected, no increases in ADC were found in any region of interest. All injury-affected regions showed decreased radial diffusivity, unchanged AD, and increased FA, which is consistent with axonal cytotoxic edema, reflective of acute injury.
Whole-brain WM DTI measures can detect abnormalities in acute mTBI associated with PCS symptoms in adolescents.
通过常规磁共振成像评估正常外观的 WM 的 DTI 在 mTBI 中具有识别与 PCS 相关的重要区域异常的潜力。VBA 用于检查急性 mTBI 中的 WM 变化。
在 10 名青少年 mTBI 患者和 10 名年龄匹配的对照组参与者中，在损伤后 1 至 6 天进行基于体素的 DTI 分析，评估 WM。除了基于体素的组分析外，还使用跨所有 mTBI 患者的分析来识别脑病理学，进行了 2 个基于体素的线性回归。这些分析调查了以下两者之间的关系：1）ADC 和 PCS 严重程度评分，以及 2）ADC 和与 mTBI 相关的 BSI 上的情绪症状评分。我们假设额颞 WM 变化与与 PCS 相关的症状以及 BSI 上的症状有关。
mTBI 患者在几个 WM 区域和左丘脑的 ADC 显著降低。正如预期的那样，在任何感兴趣的区域都没有发现 ADC 的增加。所有受损伤影响的区域显示出径向扩散率降低，AD 不变，FA 增加，这与轴突细胞毒性水肿一致，反映了急性损伤。
全脑 WM DTI 测量可以检测与青少年 PCS 症状相关的急性 mTBI 的异常。
