Jang Sung-Ho, Cho Min-Jye
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Daegu 705-717, Korea.
Diagnostics (Basel). 2022 Jun 29;12(7):1580. doi: 10.3390/diagnostics12071580.
Present review paper aims to understand role of diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) in diagnosis of traumatic axonal injury (TAI), induced by head trauma, in individual patients with a concussion or mild traumatic brain injury (mTBI). Precise information on presence and severity of TAI in brain is necessary for determining appropriate therapeutic strategies. Several hundred DTI-based studies have reported TAI in concussion or mTBI. Majority of these DTI-based studies have been performed in a group of patients, whereas case studies that have reported TAI in individual patients with a concussion or mTBI are fewer. Summary of these DTI-based studies for individual patients is as follows: DTI can be used as a non-invasive tool for determining presence and severity of TAI in individual patients with concussion or mTBI. However, for diagnosis of TAI in an individual patient, several conditions are required to be met: no past history of head trauma, presence of possible conditions for TAI occurrence during head trauma, development of new clinical features after head trauma, and DTI observed abnormality of a neural structure that coincides with a newly developed clinical feature. However, further studies for a more precise diagnosis of TAI in individual patients should be encouraged.
本综述旨在了解弥散张量成像（DTI）和弥散张量纤维束成像（DTT）在诊断因头部外伤导致的创伤性轴索损伤（TAI）中的作用，这些外伤发生在患有脑震荡或轻度创伤性脑损伤（mTBI）的个体患者中。了解大脑中TAI的存在情况和严重程度的精确信息对于确定合适的治疗策略至关重要。数百项基于DTI的研究报告了脑震荡或mTBI中的TAI情况。这些基于DTI的研究大多是在一组患者中进行的，而报告单个脑震荡或mTBI患者中TAI情况的病例研究较少。以下是这些针对个体患者的基于DTI的研究总结：DTI可作为一种非侵入性工具，用于确定单个脑震荡或mTBI患者中TAI的存在情况和严重程度。然而，对于诊断单个患者的TAI，需要满足几个条件：无头部外伤史、头部外伤期间存在TAI发生的可能条件、头部外伤后出现新的临床特征，以及DTI观察到与新出现的临床特征相符的神经结构异常。然而，应鼓励开展进一步研究，以便更精确地诊断个体患者的TAI。
