Longitudinal changes in patients with traumatic brain injury assessed with diffusion-tensor and volumetric imaging
Longitudinal changes in patients with traumatic brain injury assessed with diffusion-tensor and volumetric imaging
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DOI：
10.1016/j.neuroimage.2008.04.254
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发表时间：
2008-08-15
期刊：
影响因子：
5.7
通讯作者：
Johnson, Sterling C.
中科院分区：
文献类型：
--
作者：
Bendlin, Barbara B.;Ries, Michele L.;Johnson, Sterling C.
创伤性脑损伤(TBI)与脑体积丢失有关，但关于导致整体脑体积丢失的局部灰质(GM)和白质(WM)变化的信息很少。由于轴索损伤在颅脑损伤中是常见的，因此弥散张量成像(DTI)等对西医损害敏感的成像方法可能有助于表征导致脑外伤局部西医知识丧失的微结构脑损伤。高分辨率T1加权成像和DTI被用来评估与匹配的对照组相比，脑外伤患者的局部变化。患者接受神经心理测试，并在受伤后大约2个月和12.7个月进行成像。矛盾的是，从第一次访问到第二次访问，神经心理功能得到了改善，而基于体素的DTI图像的分数各向异性(FA)和平均扩散率(MD)的分析，以及基于体素的T1加权图像的GM和WM概率图的分析，主要显示与对照组相比，患者的有害GM和WM随时间的变化显著更大。DTI测量的横断面比较表明，与对照组相比，患者大脑大片区域的FA减少，MID增加。脑外伤几乎影响到脑中的所有主要纤维束，包括胼胝体、扣带、上下纵束、钩状束和脑尾纤维束。结果表明，GM和WM变性都是脑损伤后几个月脑体积损失的重要因素，也表明DTI测量在评估组内差异方面可能比高分辨率解剖图像更有用。由爱思唯尔公司出版。
Traumatic brain injury (TBI) is associated with brain Volume loss, but there is little information on the regional gray matter (GM) and white matter (WM) changes that contribute to overall loss. Since axonal injury is a common occurrence in TBI, imaging methods that are sensitive to WM damage Such as diffusion-tensor imaging (DTI) may be useful for characterizing microstructural brain injury contributing to regional WM loss in TBI. High-resolution T1-weighted imaging and DTI were used to evaluate regional changes in TBI patients compared to matched controls. Patients received neuropsychological testing and were imaged approximately 2 months and 12.7 months post-injury. Paradoxically, neuropsychological function improved from Visit I to Visit 2, while voxel-based analyses of fractional anisotropy (FA), and mean diffusivity (MD) from the DTI images, and voxel-based analyses of the GM and WM probability maps from the T1-weighted images, mainly revealed significantly greater deleterious GM and WM change over time in patients compared to controls. Cross-sectional comparisons of the DTI measures indicated that patients have decreased FA and increased MID compared to controls over large regions of the brain. TBI affected virtually all of the major fiber bundles in the brain including the corpus callosum, cingulum, the superior and inferior longitudinal fascicules, the uncinate fasciculus, and brain stern fiber tracts. The results indicate that both GM and WM degeneration are significant contributors to brain volume loss in the months following brain injury, and also suggest that DTI measures may be more useful than high-resolution anatomical images in assessment of group differences. Published by Elsevier Inc.