ZHANG Jing-wen1, LIU Tie-li2, MIAO Yan-wei1, WU Jian-lin3, WANG Hong-xia1
1. Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian Liaoning 116011, China;2. Faculty of Medical Imaging, Dalian Medical University, Dalian Liaoning 116044, China;3. Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian Liaoning 116001, China
Abstract:Objective: To evaluate the correlation between diffusion tensor imaging(DTI) and clinical scores in traumatic brain injury(TBI), and to explore the value of DTI in evaluating the severity of injury and to predict the prognosis of TBI. Methods: Fifty-nine cases of TBI patients with a total of 89 exams and 60 cases of matched healthy controls underwent conventional MRI and DTI exams. FA and ADC in the corpus callosum, internal capsule, and brainstem of controls and TBI patients in the acute phase, subacute phase, and 1~3 months post-trauma were measured. The data between controls and TBI patients, as well as between mild and moderate-severe TBI groups, were compared. The results of different time points were correlated with the GCS scores respectively. The differences of MRI data between different outcome groups were also analyzed. Results: FA of the majority of the observation sites was significantly reduced in the three post-injury phases of TBI patients. FA positively correlated with GCS scores significantly and the reduction of FA was more significant in poor-outcome group. Even 1~3 months after trauma, FA of the corpus callosum and internal capsule still exhibited significant decrease. ADC presented a biphasic trend with time following trauma, and its correlations with GCS and GOS scores were not as significantly as FA. Conclusion: The decreased FA correlates well with the severity of injury and can indicate the prognosis of TBI patients. Even 1~3 months after trauma, the injury of axons can still be revealed by DTI. The correlations of ADC with the injury severity and prognosis are not as sensitive and accurate as FA.