Imaging detection of cerebral microhemorrhages and white matter injuries in patients with mild traumatic brain injury and their correlation with prognosis
Objective To investigate the application of susceptibility weighted imaging(SWI)and diffusion tensor imaging(DTI)parameters in clinical diagnosis and prognosis evaluation of mild traumatic brain injury(mTBI).Methods Forty-four mTBI patients were enrolled for observation group,and 32 healthy volunteers were selected as controls.All the patients underwent conventional magnetic resonance imaging(MRI),SWI and DTI scanning of the brain.Fractional anisotropy(FA)and apparent diffusion coefficient(ADC)were measured in regions of interest(frontal lobe,genu of corpus callosum,external capsule,internal capsule,thalamus,splenium of corpus callosum,and semioval center).The Glasgow outcome Scale-Extended for traumatic brain injury(GOSE)-TBI was used to evaluate the prognosis at 6 months after discharge.FA and ADC values were compared between two groups by t-test.Correlations between imaging parameters and prognosis were analyzed by Spearman test.Results SWI showed microhemorrhages in 88.6%mTBI patients,with a mean number of 2.36±1.26(range 0-5)and a mean area of(349.48±225.82)mm2.The mean GOSE-TBI score was 7.50±0.51(range 7-8)in the observation group at 6 months after discharge,with 50.00%(22/44)of the patients scored 8.The hemorrhage area was negatively correlated with the GOSE-TBI score(P<0.001).The FA values of the frontal lobe,genu of corpus callosum and left internal capsule in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in the FA value of the thalamus between the two groups(P>0.05).The FA values of the frontal lobe and genu of corpus callosum were positively correlated with the GOSE-TBI score(P<0.001).The FA values of the internal capsule and corpus callosum splenium were negatively correlated with the GOSE-TBI score(P<0.05).There was no significant difference in the ADC values between the two groups(P>0.05).Conclusion SWI can sensitively detect microbleeds in mTBI patients.DTI shows mild white matter injury in mTBI patients.FA value is related to the GOSE-TBI score,and is a sensitive index for evaluating the severity and prognosis of mTBI.
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