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轻度创伤性脑损伤患者扩散峰度成像的纵向评估。

A longitudinal evaluation of diffusion kurtosis imaging in patients with mild traumatic brain injury.

作者信息

Stokum Jesse A, Sours Chandler, Zhuo Jiachen, Kane Robert, Shanmuganathan Kathirkamanthan, Gullapalli Rao P

机构信息

Department of Diagnostic Radiology & Nuclear Medicine .

出版信息

Brain Inj. 2015;29(1):47-57. doi: 10.3109/02699052.2014.947628. Epub 2014 Sep 26.

Abstract

PRIMARY OBJECTIVE

To investigate longitudinal diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI) changes in white and grey matter in patients with mild traumatic brain injury (mTBI).

RESEARCH DESIGN

A prospective case-control study.

METHODS AND PROCEDURES

DKI data was obtained from 24 patients with mTBI along with cognitive assessments within 10 days, 1 month and 6 months post-injury and compared with age-matched control (n¼ 24). Fractional anisotropy (FA), mean diffusivity (MD), radial diffusion (l(r)), mean kurtosis (MK) and radial kurtosis (Kr) were extracted from the thalamus, internal capsule and corpus callosum.

MAIN OUTCOMES AND RESULTS

Results demonstrate reduced Kr and MK in the anterior internal capsule in patients with mTBI across the three visits, and reduced MK in the posterior internal capsule during the 10 day time point. Correlations were observed between the change in MK or Kr between 1–6 months and the improvements in cognition between the 1 and 6 month visits in the thalamus, internal capsule and corpus callosum.

CONCLUSIONS

These data demonstrate that DKI may be sensitive in tracking pathophysiological changes associated with mTBI and may provide additional information to conventional DTI parameters in evaluating longitudinal changes following TBI.

摘要

主要目的

研究轻度创伤性脑损伤(mTBI)患者白质和灰质的纵向扩散张量成像(DTI)及扩散峰度成像(DKI)变化。

研究设计

一项前瞻性病例对照研究。

方法与步骤

获取24例mTBI患者的DKI数据,并在伤后10天、1个月和6个月进行认知评估,与年龄匹配的对照组(n = 24)进行比较。从丘脑、内囊和胼胝体提取分数各向异性(FA)、平均扩散率(MD)、径向扩散(l(r))、平均峰度(MK)和径向峰度(Kr)。

主要结果

结果显示,mTBI患者在三次随访中前内囊的Kr和MK均降低,在10天时间点后内囊的MK降低。在丘脑、内囊和胼胝体中,观察到1 - 6个月间MK或Kr的变化与1至6个月随访期间认知改善之间存在相关性。

结论

这些数据表明,DKI在追踪与mTBI相关的病理生理变化方面可能具有敏感性,并且在评估TBI后的纵向变化时,可能为传统DTI参数提供额外信息。

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