Diffusion MRI: Pitfalls, literature review and future directions of research in mild traumatic brain injury
Diffusion MRI: Pitfalls, literature review and future directions of research in mild traumatic brain injury
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DOI：
10.1016/j.ejrad.2015.11.004
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发表时间：
2016-01-01
影响因子：
3.3
通讯作者：
Krainik, Alexandre
中科院分区：
文献类型：
--
作者：
Delouche, Aurelie;Attye, Arnaud;Krainik, Alexandre
轻度创伤性脑损伤（mTBI）是成年人残疾的主要原因，其中许多人报告了身体，情绪和认知症状的痛苦组合，统称为脑震荡后综合征，在受伤后持续存在。磁共振扩散成像的重大发展，涉及通过测量分数各向异性或平均扩散率进行基于体素的定量分析，增强了我们对mTBI病理生理学不同阶段的了解。其他扩散成像衍生的技术，包括扩散峰度成像与多壳扩散和高阶纤维束成像模型，最近已证明其在mTBI的有用性。我们的综述首先简要概述了扩散张量成像的物理基础，包括用于脑创伤的陷阱，然后讨论诊断试验的结果，测试其在评估mTBI患者脑结构变化的有用性。对弥散成像数据使用不同的后处理技术，将胼胝体确定为mTBI中最常见的损伤结构，特别是在亚急性和慢性阶段，以及评估功能结果的关键位置。然而，结构变化对于使用传统扩散生物标志物的识别来说显得太微妙，因此不允许将这些技术扩展到临床实践中。在这方面，更先进的扩散技术是有希望的评估这种复杂的疾病。(C)2015爱思唯尔爱尔兰有限公司版权所有。
Mild traumatic brain injury (mTBI) is a leading cause of disability in adults, many of whom report a distressing combination of physical, emotional and cognitive symptoms, collectively known as post-concussion syndrome, that persist after the injury. Significant developments in magnetic resonance diffusion imaging, involving voxel-based quantitative analysis through the measurement of fractional anisotropy or mean diffusivity, have enhanced our knowledge on the different stages of mTBI pathophysiology. Other diffusion imaging-derived techniques, including diffusion kurtosis imaging with multi-shell diffusion and high-order tractography models, have recently demonstrated their usefulness in mTBI. Our review starts by briefly outlining the physical basis of diffusion tensor imaging including the pitfalls for use in brain trauma, before discussing findings from diagnostic trials testing its usefulness in assessing brain structural changes in patients with mTBI. Use of different post-processing techniques for the diffusion imaging data, identified the corpus callosum as the most frequently injured structure in mTBI, particularly at sub-acute and chronic stages, and a crucial location for evaluating functional outcome. However, structural changes appear too subtle for identification using traditional diffusion biomarkers, thus disallowing expansion of these techniques into clinical practice. In this regard, more advanced diffusion techniques are promising in the assessment of this complex disease. (C) 2015 Elsevier Ireland Ltd. All rights reserved.