Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, Suita, Japan.
Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Japan.
J Cereb Blood Flow Metab. 2022 Dec;42(12):2245-2254. doi: 10.1177/0271678X221113001. Epub 2022 Jul 7.
This study was aiming at investigating the extent of neuronal damage in cases of traumatic brain injury (TBI) with diffuse axonal injury (DAI) using I-iomazenil(IMZ) SPECT and MRI. We compared the findings in 31 patients with TBI without any major focal brain lesions and 25 age-matched normal controls. Subjects underwent I-IMZ SPECT and MRI, and also assessment by cognitive function tests. The partial volume effect of I-IMZ SPECT was corrected using MRI. In the patients with TBI, decreased spatial concentration of I-IMZ binding was detected in the medial frontal/orbitofrontal cortex, posterior cingulate gyrus, cuneus, precuneus, and superior region of the cerebellum. ROC analysis of I-IMZ SPECT for the detection of neuronal injury showed a high diagnostic ability of I-IMZ binding density for TBI in these areas. The decreased I-IMZ uptake density in the cuneus and precuneus was associated with cognitive decline after the injury. In the patients with TBI, brain atrophy was detected in the frontal lobe, anterior temporal and parietal cortex, corpus callosum, and posterior part of the cerebellum. Evaluation of the neuronal integrity by I-IMZ SPECT and MRI provides important information for the diagnosis and pathological interpretation in cases of TBI with DAI.
本研究旨在利用 I-iomazenil（IMZ）SPECT 和 MRI 研究外伤性脑损伤（TBI）伴弥漫性轴索损伤（DAI）患者的神经元损伤程度。我们比较了 31 例无明显局灶性脑损伤的 TBI 患者和 25 名年龄匹配的正常对照者的结果。受试者接受了 I-IMZ SPECT 和 MRI 检查，以及认知功能测试评估。使用 MRI 校正 I-IMZ SPECT 的部分容积效应。在 TBI 患者中，发现内侧额/眶额皮质、后扣带回、楔前叶、楔叶和小脑上区的 I-IMZ 结合空间浓度降低。I-IMZ SPECT 对神经元损伤的检测的 ROC 分析显示，在这些区域，I-IMZ 结合密度对 TBI 的诊断能力较高。楔叶和楔前叶的 I-IMZ 摄取密度降低与损伤后的认知能力下降有关。在 TBI 患者中，额叶、前颞叶和顶叶皮质、胼胝体和小脑后部均发现脑萎缩。I-IMZ SPECT 和 MRI 对神经元完整性的评估为 DAI 性 TBI 的诊断和病理解释提供了重要信息。
