To Xuan Vinh, Cumming Paul, Nasrallah Fatima
The Queensland Brain Institute, The University of Queensland, St. Lucia, Queensland, Australia.
Department of Nuclear Medicine, Inselspital University Hospital Bern, Bern, Switzerland.
BMJ Open Sport Exerc Med. 2024 Aug 1;10(3):e002010. doi: 10.1136/bmjsem-2024-002010. eCollection 2024.
Diagnosis and recovery tracking of mild traumatic brain injury (mTBI) is often challenging due to the lack of clear findings on routine imaging techniques. This also complicates defining safe points for returning to activities.
HYPOTHESIS/PURPOSE: Quantitative susceptibility mapping (QSM) can provide information about cerebral venous oxygen saturation (CSvO) in the context of brain injury. We tested the prediction that these imaging modalities would enable the detection of changes and recovery patterns in the brains of patients with mTBI.
In a case-control study, we recruited a cohort of 24 contact sport athletes for baseline QSM and resting-state functional MRI (rs-fMRI) scanning. Two of those who subsequently experienced head impact with significant post-injury symptoms underwent scans at 3, 7, 14 and 28 days post-injury; one had a boxing match without classical mTBI symptoms were also followed-up on.
The cohort baseline QSM measurements of the straight sinus were established. The two injured athletes with post-impact symptoms consistent with mTBI had susceptibility results at days 3 and 7 post-impact that fell below the 25th percentile of the baseline values. The per cent amplitude fluctuation quantified from rs-fMRI agreed with the susceptibility trends in the straight sinus.
QSM holds promise as a diagnostic tool for tracking mTBI progression or recovery in contact sport head injury.
由于常规成像技术缺乏明确的发现，轻度创伤性脑损伤（mTBI）的诊断和恢复跟踪往往具有挑战性。这也使得确定恢复活动的安全时间点变得复杂。
假设/目的：定量磁化率成像（QSM）可以在脑损伤的情况下提供有关脑静脉血氧饱和度（CSvO）的信息。我们测试了这些成像方式能够检测mTBI患者大脑变化和恢复模式的预测。
在一项病例对照研究中，我们招募了24名接触性运动运动员队列进行基线QSM和静息态功能磁共振成像（rs-fMRI）扫描。其中两名随后经历头部撞击并出现明显损伤后症状的运动员在受伤后3、7、14和28天进行了扫描；一名进行拳击比赛但无典型mTBI症状的运动员也进行了随访。
建立了队列中直窦的基线QSM测量值。两名有与mTBI一致的撞击后症状的受伤运动员在撞击后第3天和第7天的磁化率结果低于基线值的第25百分位数。从rs-fMRI量化的百分比振幅波动与直窦中的磁化率趋势一致。
QSM有望成为跟踪接触性运动头部损伤中mTBI进展或恢复的诊断工具。
