Department of Neurosurgery, Chhatrapati Shahuji Maharaj Medical University, Lucknow, India.
J Head Trauma Rehabil. 2010 Jan-Feb;25(1):31-42. doi: 10.1097/HTR.0b013e3181bff331.
To assess longitudinally the severity of diffuse axonal injury in the corpus callosum in patients with moderate traumatic brain injury (TBI) through quantitative diffusion tensor imaging and to correlate these changes with neuropsychometric tests (NPT) at 6 and 24 months after injury.
Prospective longitudinal study.
Sixteen patients with TBI and 17 age/sex-matched healthy controls.
Patients underwent magnetic resonance imaging at 3 time points: within 2 weeks (range = 5-14 days), 6 months, and 24 months after injury. NPT could be performed only at 6 and 24 months.
In patients with TBI, a significant increase in fractional anisotropy (FA) values in genu as well as an insignificant decrease in radial diffusivity (RD) and mean diffusivity values in genu and splenium were observed over time, respectively. FA, RD, and mean diffusivity values continued to be abnormal in patients compared with controls at the end of 2 years. Although some NPT scores improved over time in these patients, these were still significantly impaired compared with controls.
FA and RD indices appear to be surrogate markers of microstructural alterations in patients over time and correlate significantly with some of the NPT scores. The recovery in these indices associated with recovery in neurocognitive deficits suggests that these indices may be used as an objective marker for residual injury in these patients.
通过定量扩散张量成像评估中重度颅脑损伤（TBI）患者胼胝体弥散性轴索损伤的严重程度，并在损伤后 6 个月和 24 个月与神经心理测试（NPT）相关联。
前瞻性纵向研究。
16 例 TBI 患者和 17 例年龄/性别匹配的健康对照者。
患者在 3 个时间点进行磁共振成像：伤后 2 周内（范围= 5-14 天）、6 个月和 24 个月。仅在 6 个月和 24 个月可进行 NPT。
在 TBI 患者中，随着时间的推移，胼胝体体部的各向异性分数（FA）值显著增加，而径向弥散度（RD）和弥散度均值值在胼胝体体部和压部的无显著降低。与对照组相比，FA、RD 和平均弥散度值在 2 年内仍持续异常。尽管这些患者的一些 NPT 评分随时间有所改善，但与对照组相比仍明显受损。
FA 和 RD 指数似乎是患者随时间发生的微观结构改变的替代标志物，与部分 NPT 评分显著相关。这些指数与神经认知缺陷的恢复相关联，提示这些指数可能可作为这些患者残留损伤的客观标志物。
