The Study Of Enhanced T₂Star Weighted Angiography And Diffusion Tensor Imaging In Traumatic Brain Injury

Objective:To explore the value of Enhanced T2Star Weighted Angiography and Diffusiontensor imaging in Traumatic brain injury, and to analyse the correlation between theimaging findings of TBI and clinical Glasgow score.Methods:24male patients aged between4and63years with traumatic brain injury wereenrolled in the study. All the patients underwent MR scans, including T₁WI、T₂WI、DWI、T₂WI flair、DTI and ESWAN within a month after trauma. The Glasgow ComaScale assessment were carried out by neurosurgeons in admission.21volunteers agedbetween11and62years were enrolled as control subjects. All the control subjectsunderwent conventional MR sequences and DTI examination.（1） count the number oflesions on conventional MR sequences and ESWAN sequences respectively;（2） TheFA value and ADC value of each ROI were measured on21cases of TBI and21control subjects on the DTI processing images;（3） Measure the FA value and ADCvalue of ROIs at the contusion lesions and around the lesions and mirror ROIs.Statistical analysis were made by using SPSS statistical package, measuring datacompared with t test, multi-groups compared with variance analysis, ranked datacompared with Mann-Whitney U test, related factors were analyzed by pearsoncorrelation analysis, P <0.05was considered statistically significant.Results:1. The sensitivity of lesion detection were different among T₁WI, T₂WI, DWI,T₂WIFlair, DWI, ESWAN. ESWAN was significantly more sensitivity than MRconventional sequences about detecting lesions by the Friedman M test statistics. 2. The number of lesions on the ESWAN sequence was negatively correlated withclinical GCS score of TBI patients by pearson correlation analysis.3. The FA values and the ADC values were no significant differences betweenbilateral ROIs with the normal brain. The ADC values among the various ROIs wereno significant differences. The FA values were significantly different among whitematter, and no significant difference between the cerebral gray matter nuclei.4. Compared with normal control group, the FA values of corpus callosum splenium,external capsule, semi-oval center in trauma group decreased, and the FA values of therest ROIs were no differences between the two groups, the ADC values of each ROIwere no differences between the two groups by two-sample t-test.5. The FA values of the corpus callosum splenium, semi-oval center, the posteriorlimbs and anterior limb of internal capsule were correlated with clinical GCS score ofTBI patients by pearson correlation analysis.6. The FA values of the contusion lesion and around the lesions decreasedsignificantly compared with contralateral; the ADC values of the contusion lesion andaround the lesions were no significant differences compared with contralateral bypaired t-test.Conclusion:1. The ESWAN sequence is more sensitive than conventional MR sequences todetect bleeding lesions in traumatic brain injury patients, and there is good correlationbetween the imaging findings by ESWAN and clinical Glasgow score of TBI.2. The FA values reflect the pathological changes of the white matter and thedegree of injury in patients with traumatic brain injury. There is good correlationbetween the FA values and the clinical GCS score.3. Combination sequences ESWAN and DTI, not only reflect the situation ofTBI patients with cerebral hemorrhage, but also reflect cerebral axonal injury, andhelp to determine the severity of the TBI patients and evaluate the prognosis ofpatients. It is a promising imaging method for traumatic brain injury.