Volumetric MRSI Evaluation of Traumatic Brain Injury

该项目的主要目的是制定客观的措施， 中度创伤性脑损伤（MTBI）使用先进的MR神经成像方法。mTBI 是一个重大的公共卫生问题，目前的评估措施是 他们量化损伤严重程度或指示可能结果的能力有限。试点 该项目的一段时间已经证明，体积磁共振光谱 3特斯拉的磁共振成像（MRSI）可以检测到大脑中广泛的代谢变化， 随着损伤程度的增加，即使是轻度损伤，在没有明显结构MRI的情况下， 调查结果。现在建议扩展这项研究，以改善这些变化的表征 并评价MRSI和弥散加权MRI对功能性脑梗死预后的影响。 轻度和中度闭合性颅脑损伤后的结局。测量将包括 N-乙酰天冬氨酸和胆碱，已知对神经元功能障碍敏感的代谢标志物 和膜周转，以及分数各向异性，这反映了神经元的程度， organization.结果将与结构MRI、初始临床 多个时间点的功能结局评估和神经心理学评价 伤后本研究的第二个目的是检查后- 脑震荡症状，这是衰弱和持续的后果，在一小部分，这是 患者组和神经影像学测量。第三个目标是优化定量和 多参数神经成像措施，以改善表征的空间范围和 损伤的代谢后果的程度，以及它们与功能的关系， 结果测量。据推测，改进的灵敏度和空间覆盖的 所提出的神经成像措施将改善轻度和中度损伤的表征。

The primary aim of this project is to develop objective measures for evaluation of mild and moderate Traumatic Brain Injury (MTBI) using advanced MR neuroimaging methods. MTBI represents a major public health problem for which the current assessment measures are limited in their ability to quantify the severity of injury or to indicate possible outcomes. The pilot period of this project has demonstrated that Volumetric Magnetic Resonance Spectroscopic Imaging (MRSI) at 3 Tesla can detect widespread metabolic changes in the brain that correlate with the degree of injury, even for mild injury and in the absence of significant structural MRI findings. It is now proposed to extend this study to improve characterization of these changes and to evaluate the use MRSI and diffusion-weighted MRI measures for prognosis of functional outcomes following mild and moderate closed-head injury. Measurements will include N-Acetylaspartate and choline, metabolic markers known to be sensitive to neuronal dysfunction and membrane turnover, and Fractional Anisotropy, which reflects the degree of neuronal organization. Results will be correlated with findings from structural MRI, initial clinical assessments, and neuropsychological evaluation of functional outcomes at multiple time points after injury. A secondary aim of this study is to examine possible associations between post- concussive symptoms, which are debilitating and persistent consequences in a fraction of this patient group, and neuroimaging measures. A third aim is to optimize the quantitative and multiparametric neuroimaging measures to improve characterization of the spatial extent and the degree of metabolic consequences of the injury, and their associations with functional outcome measures. It is hypothesized that the improved sensitivity and spatial coverage of the proposed neuroimaging measures will improve characterization of mild and moderate injury.