Assessment On Diffuse Axonal Injury In Acute Stage Using Diffusion Tensor Imaging

Objective:Explore the value of diagnosis of early diffuse axonal injury in the joint use of diffusion tensor imaging and diffusion tensor tracking.Investigate the correlation of MRI diffusion tensor imaging at early stage between Glasgow Coma Scale and Glasgow Outcome Scale in patients with diffuse axonal injury.Methods:Twenty patients with diffuse axonal injury diagnosed by clinic and twenty healthy volunteers were underwent diffusion tensor imaging scan using Siemens1.5T superconducting MRI scanner. The fractional anisotropy, relative anisotropy, apparent diffusion coefficient axial diffusivity were quantified from different regions of interest using CREALIFE software and were compared between DAI group and control group. These ROI including genu of the corpus callosum, body of the corpus callosum, splenium of the corpus callosum, anterior limb of internal capsule, posterior limb of internal capsule and cerebral peduncle.Glasgow Coma Scale was applied to patients with diffuse axonal injury in early stage and Glasgow Outcome Scale was applied to patients with diffuse axonal injury in recovery stage six months after injury. Then correlations between the FA, RA, ADC value of DTI and neuropsychological tests score in DAI patients were analysed with Pearson linear correlation.Reconstruct three-dimensional images of the corticospinal tract, superior longitudinal fasciculus, inferior longitudinal fasciculus using CREALIFE software. Requested three experienced physicians to analysis these images.Result:1. FA values were significantly reduced in the splenium of corpus callosum(0.59±0.07), the genu of corpus callosum(0.68±0.05), the posterior internal capsule(0.64±0.03) and the pedunculus cerebr. RA values were significantly reduced in the splenium of corpus callosum(0.58±0.03), the body of corpus callosum(0.60±0.02), the posterior internal capsule(0.52±0.03) and the pedunculus cereber(0.49±0.04). ADC values were significantly reduced in the splenium of corpus callosum(0.68±0.04)and the posterior internal capsule(0.63±0.03).2. FA values were significantly correlated with GCS for the splenium of corpus callosum, the posterior internal capsule and the pedunculus cerebr. RA values were significantly correlated with GCS for the splenium of corpus callosum and the pedunculus cerebr. ADC values were significantly correlated with GCS for the splenium of corpus callosum. 3. FA values were significantly correlated with GOS for the splenium of corpus callosum and the pedunculus cerebr. RA values were significantly correlated with GOS for the splenium of corpus callosum. ADC values were no significantly correlate with GOS for the ROI.4. Diffusion tensor tractography showed fiber bundle slightly sparse or fracture in the part of injury.Conclusion:1. FA, RA, ADC values were significantly reduced in the cerebral deep medulla.DTI can detect DAI sensitive than nomal MRI, DTI is a method of diagnosis for DAI in acute stage。2. FA, RA, ADC values were significantly correlated with GCS for the cerebral deep medulla. DTI can assess the severity of DAI patient.3. FA, RA, values were significantly correlated with GOS for the cerebral deep medulla. DTI can assess out come of DAI patient.4. Diffusion tensor tractography can provid visual basis for DAI.