The Application Value Of Diffuse Tensor Imaging And Susceptibility Weighted Imaging In Mild Traumatic Brain Injury

Objective:Clinical reveal that some of mTBI patient(GCS scores13~15)shouldwould appear certain symptom(such as headache,dizziness,sickness,vegetative nervefunctional disturbance),so far as to post-concussional syndrome.To evalate theapplication value of diffuse tensor imaging (DTI) and susceptibility-weighted imaging(SWI) in mild traumatic brain injury (mTBI) patient.Materials and methods：Fifty-one cases of mTBI patients(29males,22females,mean age of37.98±15.00years,range8~66years)and twenty five cases of healthyvolunteers (age and sex matched)were exmained by MRI scanner.All ofexperimenters(GCS13~15) have no history of life ability and social functiondefects,before the injury intelligent is normal,no history of mental illness and seriouspsychosomatic illness.By post-trauma time,all of experimenters were divided into twogroups:group one(trauma one month),group two(trauma outside one month).By GESigna HD1.5T MRI scanner,Scanning sequence including aixalT1WI,T2WI,DTI andSWI. By adopting the GE ADW4.4workstation Functool data processing and usingSPIN (Signal process in NMR) software,the data that fractionalanistrophy(FA),apparent diffusion coefficient(ADC) of relevant brain regions and bloodphase value of specified veins was obtained.The data between controls and mTBIpatients,as well as between two mTBI groups were compared,and the diversity of thedata of anvaced MRI were analysed.FA and ADC in the white matter(frontal,parietal,temporal,occipital),corpuscallosum (knee,splenium,body),internal capsule (anterior limb,posterior limb),cerebralpeduncle,as well as blood phase value of specified veins (including internal cerebralvein,basal vein,superficial middle cerebral vein,superior sagittal sinus,cerebellarvein,median anterior vein of brainstem)of controls and mTBI patients were measured. Reasult：1.FA of bilateral frontal lobes,bilatera parietal lobes,body of the corpuscallosum,bilateral internal capsule(anterior limb,posterior limb),left occipital lobe andcerebral peduncle in group one were lower than those of control group,and thesedifferences are statistically significant. FA of splenium of the corpus callosum in groupone were higher than that of control group,and this difference are statisticallysignificant.2.FA of bilateral frontal lobes,bilatera parietal lobes,body of the corpuscallosum,bilateral internal capsule(anterior limb,posterior limb),right temporal lobe andcerebral peduncle in group two were lower than those of control group,and thesedifferences are statistically significant. FA of splenium of the corpus callosum in grouptwo were higher than that of control group,and the difference was statisticallysignificant.3.Between two mTBI group and control group,ADC of the left anterior limb ofcapsula interna,bilateral frontal lobes, parietal lobes, cerebral peduncle has statisticallydifference,and was higher than control.4.No significant differences of venous phase values were found in all ranges of theage.5.Between group one and control, significant differences of venous phase valuesof internal cerebral vein, superficial middle cerebral vein were found.In group one thesevenous phase values was lower than control group.In group two the venous phasevalues of superficial middle cerebral vein was lower than control group,and thedifference was statistically significant.Between two mTBI group, significant differencesof venous phase values of superficial middle cerebral vein were found. The venousphase values of group two was lower than group one.Conclusions：1.Combining the change of FA value and ADC values, that explains the existenceof the brain microstructure of changes in mild brain injury patients with clinicalsymptoms.2.In mild brain injuries, ADC vlaue of the regions of lower FA is elevated,but theregions of lower FA exceeded the regions of elevatory ADC value,and that’s also FAvalue might be more sensitive than ADC value at detecting white matter microstructureabnormalities.3.Venous phase value that was provided by SWI hints venous blood oxygen saturation level, and then reflects the change of blood oxygen metabolism and cerebralmicrocirculation after traumatic brain.4.In normal population, brain venous blood phase value has not changed at allwith age inceased.5.Through some venous phase was abnormal in mTBI patients, indicating that thelong-term existence of disturbances of cerebral microcirculation in mild brain injurypatients with clinical symptoms. So the clinical treatment and rehabilitation shall be setted along-term plan.