Department of Radiology, State University of New York, Downstate Medical Center, Brooklyn, NY, USA.
Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA.
J Neuroradiol. 2024 Sep;51(5):101211. doi: 10.1016/j.neurad.2024.101211. Epub 2024 Jun 20.
To determine the effect of mild chronic traumatic brain injury (cTBI) on cerebral blood flow and metabolism.
62 cTBI and 40 healthy controls (HCs) with no prior history of cTBI underwent both pulsed arterial spin labeling functional magnetic resonance imaging (PASL-fMRI) and fluorodeoxyglucose positron emission tomography (FDG-PET) scanning via a Siemens mMR (simultaneous PET/MRI) scanner. 30 participants also took part in a series of neuropsychological clinical measures (NCMs). Images were processed using statistical parametric mapping software relevant to each modality to generate relative cerebral blood flow (rCBF) and glucose metabolic standardized uptake value ratio (gSUVR) grey matter maps. A voxel-wise two-sample T-test and two-tailed gaussian random field correction for multiple comparisons was performed.
cTBI patients showed a significant increase in rCBF and gSUVR in the right thalamus as well as a decrease in bilateral occipital lobes and calcarine sulci. An inverse relationship between rCBF and gSUVR was found in the left frontal lobe, the left precuneus and regions in the right temporal lobe. Within those regions rCBF values correlated with 9 distinct NCMs and gSUVR with 3.
Simultaneous PASL-fMRI and FDG-PET can identify functional changes in a mild cTBI population. Within this population FDG-PET identified more regions of functional disturbance than ASL fMRI and NCMs are shown to correlate with rCBF and glucose metabolism (gSUVR) in various brain regions. As a result, both imaging modalities contribute to understanding the underlying pathophysiology and clinical course of mild chronic traumatic brain injury.
确定轻度慢性创伤性脑损伤（cTBI）对脑血流和代谢的影响。
62 例 cTBI 患者和 40 例无 cTBI 既往史的健康对照者（HCs）均接受了脉冲动脉自旋标记功能磁共振成像（PASL-fMRI）和氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）扫描，扫描仪器为西门子 mMR（同时 PET/MR）扫描仪。其中 30 名参与者还接受了一系列神经心理学临床测量（NCMs）。使用与每种模态相关的统计参数映射软件处理图像，以生成相对脑血流（rCBF）和葡萄糖代谢标准化摄取比值（gSUVR）灰质图。采用双样本 t 检验和双尾高斯随机场校正进行多比较。
cTBI 患者右侧丘脑 rCBF 和 gSUVR 显著增加，双侧枕叶和距状裂减少。左额叶、左楔前叶和右颞叶区域 rCBF 与 gSUVR 呈负相关。在这些区域，rCBF 值与 9 项不同的 NCMs 相关，gSUVR 与 3 项相关。
同时进行 PASL-fMRI 和 FDG-PET 可以识别轻度 cTBI 人群中的功能变化。在该人群中，FDG-PET 比 ASL fMRI 识别出更多功能障碍区域，NCMs 与不同脑区的 rCBF 和葡萄糖代谢（gSUVR）相关。因此，两种成像方式都有助于了解轻度慢性创伤性脑损伤的潜在病理生理学和临床过程。
