Citation

O'Phelan K, Otoshi CK, Ernst TM, Chang L. J. Neurotrauma 2018; 35(5): 739-749.

Affiliation

The Queens Medical Center, Honolulu, Hawaii, United States ; lchang@hawaii.edu.

Copyright

(Copyright © 2018, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2016.4944

PMID

29228858

Abstract

Traumatic brain injury (TBI) alters the lives of millions of people every year. Although mortality rates have improved, due to better prehospital care and reduction of secondary injury in the critical care setting, improvements in functional outcomes after TBI have been difficult to achieve. Diffusion-tensor imaging (DTI) allows detailed measurement of microstructural damage in regional brain tissue after TBI, thus improving our understanding of the extent and severity of TBI.

METHODS: Twenty subjects were recruited from a Neurological Intensive Care Unit, and compared to 18 healthy control subjects. MRI scanning was performed on a 3.0 T Siemens TIM Trio Scanner including T1- and T2-weighted sequences and DTI. Images were processed using DTIStudio software. SAS was used for statistical analysis of group differences in 14 brain regions (25 regions of interests or ROIs).

RESULTS: 17 TBI subjects completed scanning. TBI and control subjects did not differ in age or gender. All TBI subjects had visible lesions on structural MRI. TBI subjects had 7 brain regions (9 ROIs) that showed significant group differences on DTI metrics (fractional anisotropy, radial diffusion or mean diffusion) compared to non-injured subjects, including the Corpus Callosum (genu and splenium), Superior Longitudinal Fasciculus, Internal capsule, Right Retrolenticular Internal Capsule, Posterior Corona Radiata and Thalamus. However, 16 RO!s showed relatively normal DTI measures.

CONCLUSION: Quantitative DTI demonstrates multiple areas of microstructual injury in specific normal appearing white matter brain regions. DTI may be useful for assessing the extent of brain injury in patients with early moderate to severe TBI.

Language: en

Keywords

Diffusion Tensor Imaging; HEAD TRAUMA; MRI; TRAUMATIC BRAIN INJURY