Neurosurgical Department, Son Espases University Hospital, Palma de Mallorca, Spain.
Radiology Department, Son Espases University Hospital, Palma de Mallorca, Spain.
Neurocirugia (Astur : Engl Ed). 2021 Jul-Aug;32(4):161-169. doi: 10.1016/j.neucie.2020.05.001.
Cerebral edema is a frequent and serious complication of traumatic brain injury (TBI). Diffusion tensor imaging (DTI) is considered a useful technique to assess white matter integrity after TBI. The objective of this prospective, observational study was to assess the characteristics of the vasogenic edema in the traumatic pericontusional tissue and compare it to the vasogenic edema found in brain tumors. We also included a control group.
Using DTI, the Apparent diffusion coefficient (ADC) and Fractional anisotropy (FA) were measured in the area of vasogenic edema in both TBI and tumor patients. The measurements in the control group were done in the gray and white matter. We included 15 TBI patients, 18 tumor patients and 15 controls.
ADC and FA showed no differences between TBI and tumor patients (p=0.27 for AF; p=0.79 for ADC). Compared to healthy controls, TBI and tumor patients presented higher ADC values and lower FA values. The differences between TBI and controls were statistically significant (p<0.05).
In this prospective observational study using DTI-MRI in a selected group of mild and moderate TBI patients with vasogenic pericontusional edema we have shown that there were no significant differences of the ADC and FA values compared to brain tumor patients. Furthermore, healthy controls showed significant lower ADC values and higher FA values compared to TBI and tumor patients. Future studies, using DTI-MRI, should address whether any therapy has a favorable impact on the vasogenic edema of TBI patients with brain contusions.
脑水肿是颅脑创伤（TBI）的常见且严重的并发症。弥散张量成像（DTI）被认为是评估 TBI 后白质完整性的有用技术。本前瞻性观察研究的目的是评估创伤性脑损伤周边组织血管源性水肿的特征，并将其与脑肿瘤中的血管源性水肿进行比较。我们还纳入了一组对照组。
使用 DTI，分别测量 TBI 患者和肿瘤患者血管源性水肿区域的表观扩散系数（ADC）和各向异性分数（FA）。对照组的测量是在灰质和白质中进行的。我们共纳入了 15 名 TBI 患者、18 名肿瘤患者和 15 名对照组。
TBI 患者和肿瘤患者的 ADC 和 FA 之间没有差异（FA 的 p=0.27；ADC 的 p=0.79）。与健康对照组相比，TBI 和肿瘤患者的 ADC 值较高，FA 值较低。TBI 和对照组之间的差异具有统计学意义（p<0.05）。
在这项使用 DTI-MRI 的前瞻性观察研究中，我们对一组轻度和中度 TBI 伴血管源性周边水肿患者进行了研究，结果显示与肿瘤患者相比，ADC 和 FA 值没有显著差异。此外，与 TBI 和肿瘤患者相比，健康对照组的 ADC 值显著较低，FA 值显著较高。未来的研究应该使用 DTI-MRI 来确定任何治疗方法是否对 TBI 患者脑挫伤的血管源性水肿有有利影响。
