Clinical application of magnetic resonance in acute traumatic brain injury

Abstract

-Purpose:To evaluate the clinical applications of magnetic resonance imaging (MRI) in patients with acute traumatic brain injury (TBI): to identify the type, quantity, severity; and improvement clinical-radiological correlation. Method: Assessment of 55 patients who were imaged using CT and MRI, 34 (61.8%) males and 21 (38.2%) females, with acute (0 to 5 days) and closed TBI. Results: Statistical significant differences (McNemar test): ocurred fractures were detected by CT in 29.1% and by MRI in 3.6% of the patients; subdural hematoma by CT in 10.9% and MRI in 36.4 %; diffuse axonal injury (DAI) by CT in 1.8% and MRI in 50.9%; cortical contusions by CT in 9.1% and MRI in 41.8%; subarachnoid hemorrhage by CT in 18.2% and MRI in 41.8%. Conclusion: MRI was superior to the CT in the identification of DAI, subarachnoid hemorrhage, cortical contusions, and acute subdural hematoma; however it was inferior in diagnosing fractures. The detection of DAI was associated with the severity of acute TBI.Key woRDS: magnetic resonance imaging, traumatic brain injury. Aplicação clínica da ressonância magnética em pacientes com traumatismo craniencefálico agudoResumo -Propósito: Avaliar a aplicação clínica da ressonância magnética (RM) em pacientes vítimas de traumatismo craniencefálico (TCe) agudo, na identificação do tipo, número, gravidade e correlação clínica-radiológica. Método: Foram estudados prospectivamente 55 pacientes vítimas de TCe agudo fechado (0-5 dias), por TC e RM, sendo 34 do sexo masculino e 21 do feminino. Resultados: Houve diferença estatisticamente significante (teste McNemar): fraturas de crânio foram detectadas em 29,1% pacientes na TC e 3,6% pela RM; hematoma subdural 10,9% na TC e 36,4% pela RM; lesão axonal difusa (LAD) 1,8% pela TC e 50,9% na RM; contusões corticais 9,1% na TC e 41,8% pela RM, hemorragia subaracnóidea 18,2% na TC e 41,8% pela RM. Conclusão: A RM foi superior à TC na identificação da LAD, hemorragia subaracnóidea, contusões corticais e hematoma subdural agudo, porém inferior no diagnóstico de fraturas. A detecção de LAD pela RM foi associada com maior gravidade do TCe agudo. PALAVRAS-CHAVe: ressonância magnética, traumatismo craniencefálico.

MRI Characterization of Progressive Brain Alterations After Experimental Traumatic Brain Injury: Region Specific Tissue Damage, Hemodynamic Changes and Axonal Injury

“…In patients, intracerebral hemorrhage, lesion and edema formation at the acute phase are common clinical MRI findings (Caroli et al, 2001;Kurth et al, 1994;Morais et al, 2008;Scheid et al, 2007). Axonal damage following TBI has been frequently detected using diffusion tensor imaging (DTI) and the changes in diffusion anisotropy have been reported in both acute and chronic TBI patients (Sidaros et al, 2008).…”

Bioinformatics for protein biomarker panel classification: what is needed to bring biomarker panels intoin vitrodiagnostics?

“…Statistical tests should also be applied in order to judge the significance of differences between classifiers. If only two classifiers are compared, a simple binomial or McNemar test [38,86,87] can calculate the p-value to show that both classifiers are equally good [88]. Both tests are based on a 2 × 2 table, where the diagonal elements count the number of patients where both classifiers agree (either correctly or erroneously), and the off-diagonal elements indicate the number of patients where only one of the classifiers produces the right prediction.…”

Cerebrospinal fluid T1 value phantom reproduction at scan room temperature

“…Images in which the CSF is suppressed with normal MRI examination are clinically commonly used. T2‐fluid‐attenuated inversion recovery (FLAIR), T1‐FLAIR, and white matter attenuated inversion recovery (WAIR) using double inversion recovery (DIR) are clinically significant representative sequences . The most important factor affecting contrast in these inversion recovery sequences is the T1 value.…”