Study On Rs-f Mri And Diffusion Kurtosis Imaging In Hyperacute Phase Of Mild Traumatic Brain Injury

Objective:Traumatic brain injury（TBI）is an important global health issue,mTBIs are the most frequent TBIs,accounting for 70–90%of all brain injuries treated at hospitals.Unfortunately,conventional neuroimaging techniques do not have adequate sensitivity to diagnose and predict clinical outcomes of mTBI.The new technology of magnetic resonance imaging areexpected to be more sensitive and accurate in the detection of microstructural and biochemical changes that occur after mTBI.We therefore to investigate the abnormal changes of brain function and structure of the acute phase（<24h）patients with mild traumatic brain injury（mTBI）by using amplitude of low-frequency fluctuation（ALFF）in（Rs-fMRI）combined with diffusion kurtosis imaging（DKI）。To provide imaging evidence for further revealing the pathogenesis of the disease.Methods:52 mTBI patients（mTBI group）and matched 21 healthy subjects（control group）underwent rs-fMRI and DKI examination.The DPARSFsoftware was used to preprocess the fMRI data,the ALFF was compared between the mTBI and control group.The FSLsoftware was used to preprocess the DKIdata,and the white matter abnormalities were detected by tract-based spatial statistics（TBSS）and the gray matter of the thalamus were obtained by fslmeants..Results:Conventional T1,T2 weighted and FLAIR MR structure of the m TBI patients showednoobviousabnormalities.There was no significant difference in sex,age and age of education between mTBI patients and healthy subjects（p>0.05）.Compared with the healthy control group,the mTBI group showed significantly decreasing ALFF values in cerebellum posterior lobe,right middle occipital gyrus and postcentral gyrus.and the increased ALFF values inbilateral frontal lobe,bilateral caudate,medial frontal gyri and insula.we found that mTBI patients showed significantly reduced mean kurtosis（MK）in the white matter area(p_FWE<0.01):The body of corpus callosum（BCC）,the genu of corpus callosum（GCC）,the splenium of corpus callosum（SCC）,the anterior limb of interbal capsule（ALIP）,the right posterior limb of internal capsule（PLIC_R）,the anterior corona radiate（ACR）,the posterior corona radiate（PCR）,the superior corona radiate（SCR）,the left inferior fronto-occipital fasciculus（IFOF_L）and the superior longitudinal fasciculus（SLF）.However,we did not find significant differences in fractional anisotropy（FA）between groups(p_FWE>0.01).Gray matter areas:MK values in the mTBI group were lower in the left and right thalamus than in the healthy subjects,and the value of MK in the right thalamus was significantly different from that in the healthy group（P<0.05）.Conclusions:In the case of normal routine MRI findings,DKI technology showed to be more sentitive to micro structure abnormalities for patients with hyperacutemTBI and provide important imaging evidence for early clinical diagnosis.