Rehabilitation Centre, University Children's Hospital, Mühlebergstrasse 104, CH-8910 Affoltern am Albis, Switzerland; Centre for MR-Research, University Children's Hospital, Steinwiesstrasse 75, CH-8032 Zurich, Switzerland.
Department of Neuroradiology, University Hospital Zurich, Rämistrasse 100, CH-8091 Zürich. Switzerland.
Eur J Radiol. 2020 May;126:108963. doi: 10.1016/j.ejrad.2020.108963. Epub 2020 Mar 19.
To test markers from conventional and diffusion Magnetic Resonance Imaging (MRI) as possible predictors of cognitive outcome following rehabilitation therapy in children with acquired brain injury (ABI).
Twenty-one children (10 boys, mean age 11.6 years, range 7.1-19.4) with stroke or traumatic brain injury underwent MRI including Diffusion Tensor Imaging (DTI) before admission to the rehabilitation centre. The conventional images were scored according to a standardised injury scoring system, and mean Fractional Anisotropy (FA) was determined within the Corpus Callosum (CC), as this structure is hypothesised to play an important role in cognition. Both conventional MRI injury scores and mean FA of the CC and its sub-regions were compared with standard functional cognitive outcome scores. Relationships between MRI indices and cognitive outcome scores were assessed using multiple regression and receiver operating characteristic (ROC) analyses.
A backwards regression analysis revealed that the mean FA of the CC body and genu and the supratentorial injury score appear to represent the best predictors of outcome, together with the age at rehabilitation and time in rehabilitation. In the ROC analysis, the mean FA values of the CC body and genu and the infratentorial injury score provided the highest sensitivity, while the mean FA of the CC splenium showed the highest specificity for outcome.
The conventional MRI injury scores and DTI metrics from the CC reflect cognitive outcomes following rehabilitation. Neuroimaging methods such as MRI with DTI may therefore provide important markers for cognitive recovery after brain injury.
测试常规磁共振成像（MRI）和扩散 MRI 的标志物，作为获得性脑损伤（ABI）儿童康复治疗后认知结果的可能预测因子。
21 名儿童（10 名男孩，平均年龄 11.6 岁，范围 7.1-19.4）在进入康复中心之前接受了 MRI 检查，包括弥散张量成像（DTI）。常规图像根据标准化损伤评分系统进行评分，并在胼胝体（CC）内确定平均各向异性分数（FA），因为该结构被假设在认知中起重要作用。CC 的常规 MRI 损伤评分和平均 FA 与其亚区以及标准功能认知结果评分进行比较。使用多元回归和接收器操作特征（ROC）分析评估 MRI 指数与认知结果评分之间的关系。
向后回归分析显示，CC 体部和膝部的平均 FA 以及幕上损伤评分似乎是预测结果的最佳指标，与康复时的年龄和康复时间有关。在 ROC 分析中，CC 体部和膝部的平均 FA 值和幕下损伤评分提供了最高的敏感性，而 CC 压部的平均 FA 值提供了最高的特异性。
常规 MRI 损伤评分和 CC 的 DTI 指标反映了康复后的认知结果。因此，磁共振成像（MRI）等神经影像学方法可能为脑损伤后的认知恢复提供重要的标志物。
