A Longitudinal Magnetic Resonance Imaging Study of the Apparent Diffusion Coefficient Values in Corpus Callosum during the First Year after Traumatic Brain Injury

Abstract

The objective of this study was to explore the evolution of apparent diffusion coefficient (ADC) values in magnetic resonance imaging (MRI) in normal-appearing tissue of the corpus callosum during the 1st year after traumatic brain injury (TBI), and relate findings to outcome. Fifty-seven patients (mean age 34 [range 11-63] years) with moderate to severe TBI were examined with diffusion weighted MRI at three time points (median 7 days, 3 and 12 months), and a sexand age-matched control group of 47 healthy individuals, were examined once. The corpus callosum was subdivided and the mean ADC values computed blinded in 10 regions of interests without any visible lesions in the ADC map. Outcome measures were Glasgow Outcome Scale Extended (GOSE) and neuropsychological domain scores at 12 months. We found a gradual increase of the mean ADC values during the 12 month follow-up, most evident in the posterior truncus (r = 0.19, p < 0.001). Compared with the healthy control group, we found higher mean ADC values in posterior truncus both at 3 months ( p = 0.021) and 12 months ( p = 0.003) post-injury. Patients with fluid-attenuated inversion recovery (FLAIR) lesions in the corpus callosum in the early MRI, and patients with disability (GOSE score £ 6) showed evidence of increased mean ADC values in the genu and posterior truncus at 12 months. Mean ADC values in posterior parts of the corpus callosum at 3 months predicted the sensory-motor function domain score ( p = 0.010-0.028). During the 1st year after moderate and severe TBI, we demonstrated a slowly evolving disruption of the microstructure in normal appearing corpus callosum in the ADC map, most evident in the posterior truncus. The mean ADC values were associated with both outcome and ability to perform speeded, complex sensory-motor action.

Traumatic Axonal Injury: The Prognostic Value of Lesion Load in Corpus Callosum, Brain Stem, and Thalamus in Different Magnetic Resonance Imaging Sequences

“…For more details on regions I-V of the corpus callosum, we refer the reader to the Methods section or Moen and colleagues. 22 No significant differences between the ''all TBI'' patients and the controls ( p = 1.0) were found in any regions (MWU with Bonferroni's correction). No significant differences between the patients with MRI £ 7 days versus 8-28 days postinjury ( p = 0.69-1.0) were found in any regions (MWU with Bonferroni's correction).…”

“…More details of diffusion MRI acquisition has been described earlier. 22 Counting of lesions in the different magnetic resonance imaging sequences…”

“…For all cases and controls, ADC measurements were computed by placing 10 circle-shaped ROIs with a radius of 1.8 mm in five predefined anatomical locations in the corpus callosum (regions I-V). 22 For 5 patients it was impossible to assess ADC values; in two of them due to massive callosal injury, making it impossible to place ROIs in normal appearing tissue. For two of the others, the quality of the ADC map was insufficient and for the fifth patient the whole ADC map was missing.…”

Use of multisequence 3.0-T MRI to detect severe traumatic brain injury and predict the outcome

“…33 Previous studies suggest that changes of ADC values in the corpus callosum and BS are associated with the outcomes. 23,34,35 We quantitatively tested the water diffusion in the predilection areas of DAI (CS, corpus callosum and BS) and found that the increased ADC values in patients with TBI were comparable to those in the control subjects, which can be explained by the compromised obstruction of the broken axonal membrane, or they may be due to residual oedema. The ADC values in the CCS and BS were significantly increased in patients with unfavourable outcomes, and the ADC ccs proved to be an independent risk factor for poor prognosis.…”

Quantification of apparent diffusion coefficient and relative cerebral blood volume for analysis concerning gender and age as determinant factors in glioma prospect

“…Anterior studies were conducted either on the basis of retrospective, social or statistical methods to ascertain a possible correlation between age, gender and occurrence of brain tumors [11][12][13][14][15][16][17][18]21].…”