Clinical Application Of DTI In Mild Traumatic Brain Injury And Its Significance

Objective:Mild traumatic brain injury was common. In spite of normal head CT findings, reports of post-concussion symptoms(PCS) were common following MTBI. Although these symptoms could resolve within weeks to a few months, they persisted in a minority of cases, diminishing quality of life for these patients. The purpose of this study was to detect the type and distribution of intracranial lesions after mild traumatic brain injury using diffusion tensor imaging(DTI), and assess the application of DTI in mild traumatic brain injury clinically. Correlating clinical manifestations of PCS with those tiny to explore the relation between neuroimaging indices and behavioral data.Methods: 50 patients were prospectively enrolled from Tianjin First Center Hospital, who sustained a mild TBI within 7 days. 50 normal volunteers were also recruited as control. All the participants underwent T1 WI,T2WI,DWI,SWI, and DTI scanning, and Rivermead Post Concussion Symptoms Questionnaire(RPQ) within the day of examination. Divided the m TBI patients into two groups. The m TBI 1 group were those with positive findings in SWI, whereas the m TBI 2 group were the other patients. Then compare the two groups’ DTI data and RPQ scores with the controls’ respectively.Results: Female mTBI patients had higher RPQ scores than male m TBI patients.(P<0.01). The RPQ scores of m TBI 1 group, m TBI 1 group and control had statistical group difference(P<0.01). Both RPQ scores of m TBI 1 and 2 group had a higher RPQ than the controls(P<0.01), however the two groups’ RPQ scores didn’t show statistical group difference(P>0.05). In FA data, there were 32 abnormal regions between m TBI 1 group and controls, 30 region’s FA values higher than normal and 2 region’s lower. Analyses revealed 7 abnormal regions between m TBI 2 group and controls, 3 region’s FA values higher than normal and 4 region’s lower(P<0.01). In ADC data, there were 34 abnormal regions between m TBI 1 group and controls, 5 region’s ADC values higher than normal and 29 region’s lower. Analysesrevealed 7 abnormal regions between m TBI 2 group and controls, 1 region’s ADC values higher than normal and 6 region’s lower(P<0.01).Conclusion: MTBI was more common in males, especially in young adults. Most patients suffered PCSs such as headache, dizzy, etc. Female sex is associated with signi?cantly higher odds of poor outcome after m TBI, as measured by PCS score. Neural tissue damage following m TBI was referred to as diffuse axon injury(DAI). It is often subtle and difficult to detect, with normal head CT and MRI findings. DTI can identify intracranial latent lesion in patients following m TBI, which was much more sensitive than SWI and routine MRI. The type of lesions in the acute stage included axon injury, cytotoxic edema and secondary inflammation. The present study also shows that patients with m TBI have multiple regions with abnormally in the cerebral cortex and subcortical white matter, corpus callosum. However the many more abnormalities in deep brain such as basal ganglia suggested that deep brain abnormalities may be more associated with severe damage. We believed DTI shows promise for enhancing the clinical care of m TBI patients as it could play a role in the diagnosis of brain injury not revealed using conventional imaging.