Use of diffusion tensor imaging to examine subacute white matter injury progression in moderate to severe traumatic brain injury.

摘要

OBJECTIVE: To demonstrate subacute progression of white matter (WM) injury (4.5mo-2.5y postinjury) in patients with traumatic brain injury using diffusion-tensor imaging. DESIGN: Prospective, repeated-measures, within-subjects design. SETTING: Inpatient neurorehabilitation program and teaching hospital MRI department. PARTICIPANTS: Brain-injured adults (N=13) with a mean Glasgow Coma Scale score of 7.67+/-4.16. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Fractional anisotropy (FA) values were measured at 4.5 and 29 months postinjury in right and left frontal and temporal deep WM tracts and the anterior and posterior corpus callosum. RESULTS: FA significantly decreased in frontal and temporal tracts: right frontal (.38+/-.06 to .30+/-.06; P<.005), left frontal (.37+/-.06 to .32+/-.06; P<.05), right temporal (.28+/-.05 to .22+/-.018; P<.005), and left temporal (.28+/-.05 to .24+/-.02; P<.05). No significant changes were in the corpus callosum. CONCLUSIONS: Preliminary results demonstrate progression of WM damage as evidenced by interval changes in diffusion anisotropy. Future research should examine the relationship between decreased FA and long-term clinical outcome.