Környei Bálint S, Szabó Viktor, Perlaki Gábor, Balogh Bendegúz, Szabó Steigerwald Dorottya K, Nagy Szilvia A, Tóth Luca, Büki András, Dóczi Tamás, Bogner Péter, Schwarcz Attila, Tóth Arnold
Department of Medical Imaging, Medical School, University of Pécs, Pécs, Hungary.
Department of Neurosurgery, Medical School, University of Pécs, Pécs, Hungary.
Front Neurosci. 2021 Sep 30;15:711074. doi: 10.3389/fnins.2021.711074. eCollection 2021.
A former rodent study showed that cerebral traumatic microbleeds (TMBs) may temporarily become invisible shortly after injury when detected by susceptibility weighted imaging (SWI). The present study aims to validate this phenomenon in human SWI. In this retrospective study, 46 traumatic brain injury (TBI) patients in various forms of severity were included and willingly complied with our strict selection criteria. Clinical parameters potentially affecting TMB count, Rotterdam and Marshall CT score, Mayo Clinic Classification, contusion number, and total volume were registered. The precise time between trauma and MRI [5 h 19 min to 141 h 54 min, including SWI and fluid-attenuated inversion recovery (FLAIR)] was individually recorded; TMB and FLAIR lesion counts were assessed. Four groups were created based on elapsed time between the trauma and MRI: 0-24, 24-48, 48-72, and >72 h. Kruskal-Wallis, ANOVA, Chi-square, and Fisher's exact tests were used to reveal differences among the groups within clinical and imaging parameters; statistical power was calculated retrospectively for each comparison. The Kruskal-Wallis ANOVA with Conover analysis showed significant ( = 0.01; 1-β > 0.9) median TMB number differences in the subacute period: 0-24 h = 4.00 ( = 11); 24-48 h = 1 ( = 14); 48-72 h = 1 ( = 11); and 72 h ≤ 7.5 ( = 10). Neither clinical parameters nor FLAIR lesions depicted significant differences among the groups. Our results demonstrate that TMBs on SWI MRI may temporarily become less detectable at 24-72 h following TBI.
一项先前的啮齿动物研究表明，脑外伤性微出血（TMBs）在损伤后不久通过磁敏感加权成像（SWI）检测时可能会暂时变得不可见。本研究旨在在人体SWI中验证这一现象。在这项回顾性研究中，纳入了46例各种严重程度的创伤性脑损伤（TBI）患者，他们均自愿遵守我们严格的选择标准。记录了可能影响TMB计数的临床参数、鹿特丹和马歇尔CT评分、梅奥诊所分类、挫伤数量和总体积。单独记录了创伤与磁共振成像（MRI）[5小时19分钟至141小时54分钟，包括SWI和液体衰减反转恢复序列（FLAIR）]之间的确切时间；评估了TMB和FLAIR病变计数。根据创伤与MRI之间的时间间隔分为四组：0 - 24小时、24 - 48小时、48 - 72小时和>72小时。使用Kruskal - Wallis检验、方差分析、卡方检验和Fisher精确检验来揭示临床和影像参数组间的差异；对每次比较进行回顾性统计功效计算。采用带有Conover分析的Kruskal - Wallis方差分析显示，亚急性期TMB中位数存在显著差异（P = 0.01；检验效能>0.9）：0 - 24小时 = 4.00（n = 11）；24 - 48小时 = 1（n = 14）；48 - 72小时 = 1（n = 11）；72小时≤7.5（n = 10）。临床参数和FLAIR病变在各组之间均未显示出显著差异。我们的结果表明，TBI后24 - 72小时，SWI MRI上的TMB可能会暂时变得更难检测到。
