Diffusion tensor imaging as potential biomarker of white matter injury in diffuse axonal injury.
Diffusion tensor imaging as potential biomarker of white matter injury in diffuse axonal injury.
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发表时间：
2004-03
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通讯作者：
T. Huisman;L. Schwamm;P. Schaefer;W. Koroshetz;N. Shetty-Alva;Y. Ozsunar;O. Wu;A. Sorensen
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作者：
T. Huisman;L. Schwamm;P. Schaefer;W. Koroshetz;N. Shetty-Alva;Y. Ozsunar;O. Wu;A. Sorensen
背景和目的多种生物标志物用于量化创伤性脑损伤（TBI）的严重程度并预测结果。很少有人满意。CT和常规MR成像低估了损伤，与预后相关性差。新的磁共振成像技术，包括扩散张量成像（DTI），可以通过量化各向同性和各向异性水扩散提供有关脑超微结构的信息。我们的目的是确定TBI各向异性弥散的变化是否与急性格拉斯哥昏迷评分（GCS）和/或出院时的兰金评分相关。方法20例患者（男15例，女5例;平均年龄31岁）进行了评估。在多个位置测量表观扩散系数（ADC）和各向异性分数（FA）值，并与临床评分相关。并与15例健康对照组进行比较。结果压部ADC值显著降低（Δ 18%，P = 0.001）。内囊（Δ 14%; P <0.001）和压部（Δ 16%; P = 0.002）的FA值显著降低。FA值与内囊和压部的GCS（r = 0.65-0.74; P <0.001）和兰金（r = 0.68-0.71; P <0.001）评分显著相关。FA和临床指标之间的相关性优于相应的ADC值。内囊ADC值与GCS/兰金评分无相关性。结论脑白色改变与急性GCS评分及出院时兰金评分相关。DTI可能是一个有价值的生物标志物的组织损伤的严重程度和预后的预测。
BACKGROUND AND PURPOSE Multiple biomarkers are used to quantify the severity of traumatic brain injury (TBI) and to predict outcome. Few are satisfactory. CT and conventional MR imaging underestimate injury and correlate poorly with outcome. New MR imaging techniques, including diffusion tensor imaging (DTI), can provide information about brain ultrastructure by quantifying isotropic and anisotropic water diffusion. Our objective was to determine if changes in anisotropic diffusion in TBI correlate with acute Glasgow coma scale (GCS) and/or Rankin scores at discharge. METHODS Twenty patients (15 male, five Female; mean age, 31 years) were evaluated. Apparent diffusion coefficients (ADCs) and fractional anisotropy (FA) values were measured at multiple locations and correlated with clinical scores. Results were compared with those of 15 healthy control subjects. RESULTS ADC values were significantly reduced within the splenium (Delta18%, P =.001). FA values were significantly reduced in the internal capsule (Delta14%; P <.001) and splenium (Delta16%; P =.002). FA values were significantly correlated with GCS (r = 0.65-0.74; P <.001) and Rankin (r = 0.68-0.71; P <.001) scores for the internal capsule and splenium. The correlation between FA and clinical markers was better than for the corresponding ADC values. No correlation was found between ADC of the internal capsule and GCS/Rankin scores. CONCLUSION DTI reveals changes in the white matter that are correlated with both acute GCS and Rankin scores at discharge. DTI may be a valuable biomarker for the severity of tissue injury and a predictor for outcome.