Diffusion-weighted MRI in diffuse axonal injury of the brain
Diffusion-weighted MRI in diffuse axonal injury of the brain
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DOI：
10.1007/s00330-002-1333-2
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发表时间：
2002-10-01
影响因子：
5.9
通讯作者：
Huisman, TAGM
中科院分区：
文献类型：
--
作者：
Hergan, K;Schaefer, PW;Huisman, TAGM
本研究的目的是确定和描述不同类型和模式的组织损伤，这是遇到的扩散加权成像（DWI）在弥漫性轴索损伤（DAI）的大脑。回顾性评价了98例闭合性颅脑损伤患者的DWI数据集。审查了医疗记录，以排除先前存在的神经系统疾病。研究病变的DWI信号特征和病变大小或范围。根据DWI和表观扩散系数（ADC）图上的信号特征，将创伤性病变分为三类：1型，DWI和ADC高信号，最可能代表血管源性水肿病变; 2型，DWI高信号，ADC低信号，表明细胞毒性水肿; 3型，中心出血性病变周围扩散增加。根据损伤的大小和范围，将损伤分为三组：A组，局灶性损伤; B组，区域/融合性损伤; C组，广泛/弥漫性损伤。我们的研究表明弥散加权成像可以区分弥漫性轴索损伤患者弥散功能减弱和增强的病变。观察到不同程度的组织损伤程度。未来的前瞻性研究应该研究这些额外的信息是否可以用作损伤可逆性、最终结果和预后的预测因子。
The goal of this study was to identify and describe the different types and patterns of tissue injury which are encountered by diffusion-weighted imaging (DWI) in diffuse axonal injury (DAI) of the brain. The DWI data sets of 98 patients who suffered from a closed-head injury were retrospectively evaluated. Medical records were reviewed to rule out pre-existing neurological diseases. Lesions were studied for their DWI signal characteristics and lesion size or extension. Traumatic lesions were classified into three categories depending on their signal characteristica on DWI and apparent diffusion coefficient (ADC) maps: type 1, DWI- and ADC-hyperintense most likely representing lesions with vasogenic edema; type 2, DWI-hyperintense, ADC-hypointense indicating cytotoxic edema; type 3, central hemorrhagic lesion surrounded by an area of increased diffusion. According to the size and extent of lesions, injury was classified into three groups: group A, focal injury; group B, regional/confluent injury; and group C, extensive/diffuse injury. Our study showed that diffusion-weighted imaging differentiates between lesions with decreased and increased diffusion in patients with DAI. Different degrees of tissue injury extent were noticed. Future prospective studies should study if this additional information can be used as a predictor of injury reversibility, final outcome and prognosis.