Decreased susceptibility of major veins in mild traumatic brain injury is correlated with post-concussive symptoms: A quantitative susceptibility mapping study.
Decreased susceptibility of major veins in mild traumatic brain injury is correlated with post-concussive symptoms: A quantitative susceptibility mapping study.
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轻度创伤性脑损伤中主要静脉的敏感性降低与脑震荡后症状相关：定量敏感性图谱研究
DOI：
10.1016/j.nicl.2017.06.008
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Shen W
中科院分区：
文献类型：
--
作者：
Chai C;Guo R;Zuo C;Fan L;Liu S;Qian T;Mark Haacke E;Xia S;Shen W
脑静脉氧饱和度（SvO2）是脑功能的重要生物标志物。在本研究中，我们旨在利用定量磁敏图（QSM）探讨轴突损伤（AI）患者、非AI患者和健康对照（HC）中局部脑SvO2的相对变化。纳入了 48 名患者和 32 名 HC。根据人工智能的成像证据，将患者分为两组。 QSM用于测量主要脑静脉的敏感性。对非AI患者组、AI患者组和健康对照组之间的敏感性差异进行非参数检验。主要脑静脉的敏感性、创伤后经过时间（ETPT）和脑震荡后症状评分之间存在相关性。 ROC 分析的目的是为了区分 mTBI 患者和 HC 的敏感性的诊断效率。非 AI 和 AI 患者的直窦敏感性显着低于 HC（P < 0.001，P = 0.004，分别经 Bonferroni 校正），这可能表明患者局部脑 SvO2 增加。非 AI 患者的直窦敏感性与 ETPT 呈正相关（r = 0.573，P = 0.003，FDR 校正），而 AI 患者的直窦敏感性与 Rivermead 脑震荡后症状问卷评分呈负相关（r = − 0.582，P = 0.018，FDR 校正）。区分 mTBI 患者和 HC 的敏感性、特异性和 AUC 值分别为 88%、69% 和 0.84。总之，直窦的敏感性可用作监测轻度 TBI 进展并区分 mTBI 患者与健康对照的生物标志物。轻度创伤性脑损伤导致静脉敏感性降低。静脉敏感性可以将 mTBI 患者与健康对照区分开来。敏感性降低可能表明静脉氧饱和度 (SvO2) 增加。无轴突损伤患者的 SvO2 增加值随着损伤后时间的延长而降低。轴突损伤患者的 SvO2 增加表明有严重的脑震荡后症状。
Cerebral venous oxygen saturation (SvO2) is an important biomarker of brain function. In this study, we aimed to explore the relative changes of regional cerebral SvO2 among axonal injury (AI) patients, non-AI patients and healthy controls (HCs) using quantitative susceptibility mapping (QSM). 48 patients and 32 HCs were enrolled. The patients were divided into two groups depending on the imaging based evidence of AI. QSM was used to measure the susceptibility of major cerebral veins. Nonparametric testing was performed for susceptibility differences among the non-AI patient group, AI patient group and healthy control group. Correlation was performed between the susceptibility of major cerebral veins, elapsed time post trauma (ETPT) and post-concussive symptom scores. The ROC analysis was performed for the diagnostic efficiency of susceptibility to discriminate mTBI patients from HCs. The susceptibility of the straight sinus in non-AI and AI patients was significantly lower than that in HCs (P < 0.001, P = 0.004, respectively, Bonferroni corrected), which may indicate an increased regional cerebral SvO2 in patients. The susceptibility of the straight sinus in non-AI patients positively correlated with ETPT (r = 0.573, P = 0.003, FDR corrected) while that in AI patients negatively correlated with the Rivermead Post Concussion Symptoms Questionnaire scores (r = − 0.582, P = 0.018, FDR corrected). The sensitivity, specificity and AUC values of susceptibility for the discrimination between mTBI patients and HCs were 88%, 69% and 0.84. In conclusion, the susceptibility of the straight sinus can be used as a biomarker to monitor the progress of mild TBI and to differentiate mTBI patients from healthy controls. Mild traumatic brain injury caused decreased venous susceptibility. The venous susceptibility can discriminate mTBI patients from healthy controls. Decreased susceptibility may indicate increased venous oxygen saturation (SvO2). Increased SvO2 of patients without axonal injury decreased with time post-injury. Increased SvO2 of axonal injury patients indicated severe post-concussive symptoms.