1 Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin.
2 Department of Pathology, Pediatric Division, and Medical College of Wisconsin, Milwaukee, Wisconsin.
J Neurotrauma. 2019 Jun;36(11):1776-1785. doi: 10.1089/neu.2018.6055. Epub 2019 Feb 25.
Previous studies have shown that mild traumatic brain injury (mTBI) can cause abnormalities in clinically relevant magnetic resonance imaging (MRI) sequences. No large-scale study, however, has prospectively assessed this in athletes with sport-related concussion (SRC). The aim of the current study was to characterize and compare the prevalence of acute, trauma-related MRI findings and clinically significant, non-specific MRI findings in athletes with and without SRC. College and high-school athletes were prospectively enrolled and participated in scanning sessions between January 2015 through August 2017. Concussed contact sport athletes ( = 138; 14 female [F]; 19.5 ± 1.6 years) completed up to four scanning sessions after SRC. Non-concussed contact ( = 135; 15 F; 19.7 ± 1.6) and non-contact athletes ( = 96; 15 F; 20.0 ± 1.7) completed similar scanning sessions and served as controls. Board-certified neuroradiologists, blinded to SRC status, reviewed T-weighted and T-weighted fluid-attenuated inversion recovery and T*-weighted and T-weighted images for acute (i.e., injury-related) or non-acute findings that prompted recommendation for clinical follow-up. Concussed athletes were more likely to have MRI findings relative to contact (30.4% vs. 15.6%; odds ratio [OR] = 2.32; = 0.01) and non-contact control athletes (19.8%; OR = 2.11; = 0.04). Female athletes were more likely to have MRI findings than males (43.2% vs. 19.4%; OR = 2.62; = 0.01). One athlete with SRC had an acute, injury-related finding; group differences were largely driven by increased rate of non-specific white matter hyperintensities in concussed athletes. This prospective, large-scale study demonstrates that <1% of SRCs are associated with acute injury findings on qualitative structural MRI, providing empirical support for clinical guidelines that do not recommend use of MRI after SRC.
先前的研究表明，轻度创伤性脑损伤（mTBI）可导致临床上相关的磁共振成像（MRI）序列异常。然而，尚无大型前瞻性研究评估运动相关性脑震荡（SRC）运动员中的这种情况。本研究的目的是描述和比较 SRC 运动员与无 SRC 运动员的急性、创伤相关 MRI 表现和临床意义、非特异性 MRI 表现的发生率。大学和高中运动员于 2015 年 1 月至 2017 年 8 月期间前瞻性入组并参加扫描。患有 SRC 的接触性运动运动员（ = 138；14 名女性 [F]；19.5±1.6 岁）在 SRC 后最多完成了 4 次扫描。非 SRC 接触性（ = 135；15 名女性 [F]；19.7±1.6）和非接触性运动员（ = 96；15 名女性 [F]；20.0±1.7）完成了类似的扫描并作为对照组。经过 board-certified 神经放射科医师进行了盲法评估，根据 T1 加权和 T1 加权液体衰减反转恢复、T*-加权和 T1 加权图像评估急性（即与损伤相关）或非急性发现，这些发现提示需要临床随访。与接触性运动（30.4% vs. 15.6%；优势比 [OR] = 2.32； = 0.01）和非接触性对照组运动员（19.8%；OR = 2.11； = 0.04）相比，患有 SRC 的运动员更有可能出现 MRI 结果。女性运动员比男性更有可能出现 MRI 结果（43.2% vs. 19.4%；OR = 2.62； = 0.01）。一名 SRC 运动员出现了一处急性、与损伤相关的表现；组间差异主要归因于患有 SRC 的运动员中白质高信号的非特异性表现发生率增加。这项前瞻性、大规模研究表明，<1%的 SRC 与定性结构 MRI 上的急性损伤表现相关，为不建议在 SRC 后使用 MRI 的临床指南提供了实证支持。
