From the Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Taegu, Republic of Korea.
Am J Phys Med Rehabil. 2019 Aug;98(8):e92-e96. doi: 10.1097/PHM.0000000000001078.
We describe a diffusion tensor tractography-based diagnostic approach to traumatic axonal injury of the optic radiation in a patient who showed visual field defect after mild traumatic brain injury. A 43-yr-old female patient experienced head trauma during a motor vehicle accident. After the head trauma, she noticed visual disturbance. Peripheral field defects were detected in both eyes on the Humphrey visual field test. After diffusion tensor tractography-based reconstruction of the optic radiation, We determined the fractional anisotropy and fiber number of each whole optic radiation. Four regions of interest were placed on the optic radiations based on diffusion tensor tractography configuration. The right optic radiation showed narrowing, and the left optic radiation revealed partial tearing in the posterior portion. The fiber number of the right optic radiation was more than two standard deviations lower than the control mean. The fractional anisotropy values of the regions of interest 2 (the narrowed area of the right optic radiation) and regions of interest 3 (the partially torn area of the left optic radiation) were more than two standard deviations lower than the control mean. Our results suggest that analysis of the configuration and parameters of the optic radiation based on three-dimensionally reconstructed diffusion tensor tractography results is a useful technique in the detection of traumatic axonal injury of the optic radiation in individual patients with mild traumatic brain injury.
我们描述了一种基于弥散张量纤维束追踪的诊断方法，用于诊断轻度颅脑损伤后出现视野缺损的视辐射外伤性轴索损伤患者。一名 43 岁女性患者在一场机动车事故中头部受伤。头部受伤后，她注意到视力障碍。Humphrey 视野测试显示双眼存在周边视野缺损。在基于弥散张量纤维束追踪的视辐射重建后，我们确定了每个完整视辐射的各向异性分数和纤维数量。根据弥散张量纤维束追踪配置，在视辐射上放置了 4 个感兴趣区。右侧视辐射变窄，左侧视辐射后部部分撕裂。右侧视辐射的纤维数量比对照平均值低两个标准差以上。感兴趣区 2（右侧视辐射狭窄区域）和感兴趣区 3（左侧视辐射部分撕裂区域）的各向异性分数值均比对照平均值低两个标准差以上。我们的结果表明，基于三维重建弥散张量纤维束追踪结果对视辐射的形态和参数进行分析，是检测轻度颅脑损伤患者视辐射外伤性轴索损伤的一种有用技术。
