Diffusion Tensor Imaging For Evaluating White Matter Fiber Tracts In Patients With Mild Traumatic Brain Injury

Mild traumatic brain injury(mTBI) is the most common traumatic injury. also referred to as concussion, remains a controversial diagnosis because the brain often appears quite normal on conventional computed tomography(CT) and magnetic resonance imaging(MRI) scans. after injury of 24 h the Glasgow coma scale(Glas-gow coma scale, GCS) scoring 13 points or more. It is difficult to detect mTBI using a routine neuroimaging. Advanced techniques with greater sensitivity and specificity for the diagnosis and treatment of mTBI are required. symptoms that include dizziness, headache, irritability, fatigue, sleep disturbances, nausea, blurred vision, hypersensitivity to light and noise, depression, anxiety, memory, executive function, and speed of processing and so on. Mild traumatic brain injury(mTBI) can have a profoundly negative effect on the injured person’s quality of life, producing cognitive, physical, and psychological symptoms; impeding postinjury family reintegration; creating psychological distress among family members; and often having deleterious effects on spousal and parental relationships. Advanced techniques with greater sensitivity and specificity for the diagnosis and treatment of mTBI are required advanced techniques with greater sensitivity and specificity for the diagnosis and treatment of mTBI are required. the challenge is thus to use neuroimaging tools that are sensitive to mTBI, such as diffusion tensor imaging(DTI), in order to detect brain injuries in mTBI. Of note here, recent advances in neuroimaging techniques, such as diffusion tensor imaging(DTI), make it possible to characterize better extant brain abnormalities in mTBI.DTI is a sensitive measure of axonal injury that is particularly important for evaluating small and subtle brain alterations that are characteristic of most mTBI. DTI will also likely become an important diagnostic tool for individual cases of mTBI, particularly where MR and CT are negative. In recent years, an increasing number of DTI studies on white matter(WM) have been conducted in patients with mTBI, however, the results are not consistent. Some studies reported reduced FA values and elevated diffusivity(ADC, MD and RD) in the WM regions in patients with mTBI, while other studies reported increased FA values and reduced diffusivity in the WM regions in patients with mTBI. Such tools will likely be used in future research to evaluate treatment efficacy, given their enhanced sensitivity to alterations in the brain. This study was to detect the changes of white matter fiber tracts in mild traumatic brain injury patients by using DTI technique on GE 3.0TMR scanner, and evaluate the clinical diagnostic value of DTI.Objective:To study the changes of white matter fiber tracts in mild traumatic brain injury patients by using DTI technique on GE 3.0TMR scanner, and evaluate the clinical diagnostic value of DTI.Method:Thirty mild TBI and 30 matched healthy controls underwent conventional CT and MRI and DTI.FA values and ADC values in the genu of the corpus callosum, the splenium of the corpus callosum, internal capsulethe, bilaterally, the cingulum bundle, the superior longitudinal fasciculus, and the inferior longitudinal fasciculus of mTBI patients in acute phase, subacute phase, 5 weeks-3 months post-trauma and controls were measured and compared. The temporal changes of MRI data were observed.Results:FA values in the part of the white matter fiber tracts reduced in the acute and subacute phase of mild TBI patients(all P<0.05), slightly lower than those of the controls(all P<0.05) in 5 weeks-3 months post-trauma. As for the genu of the corpus callosum and the splenium of the corpus callosum, the FA vaules in the acute stage exceptionally mildly elevated(all P>0.05) and decreased thereafter. Even in 5weeks-3 months post-trauma phase, their FA values still were significantly different compared with healthy controls(all P>0.05). ADC values significantly decreased in the in the acute and subacute phase of mild TBI patients, and went up thereafter(all P>0.05).Conclusion:The sensitivity of DTI to mild traumatic brain damage is higher, and it can display the damage of white matter, which is develop to visualize. DTI can play an important role in the diagnosis of mTBI.