Diffuse axonal injury: detection of changes in anisotropy of water diffusion by diffusion-weighted imaging

Chan, J. H. M.; Tsui, Edmund; Peh, Wilfred C. G.; Fong, Dawson; Fok, K. F.; Leung, Kwok-Sui; Yuen, Ming Keung; Fung, Karl Ka Lok

doi:10.1007/s00234-002-0891-y

Cited by 56 publications

(37 citation statements)

References 20 publications

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“…Even though no large-scale DWI studies have been performed, a DWI study of 10 patients in the chronic phase showed increased mean ADC values in ROIs in the corpus callosum both in lesion and non-lesion areas. 14 The existing DTI studies addressing diffusivity in the corpus callosum in the chronic phase following TBI also support our findings. In a study of 30 TBI patients, higher MD was observed in the posterior corpus callosum at 12 months compared with healthy controls.…”

Section: Mean Adc Values and Comparison With Controlssupporting

confidence: 87%

“…[11][12][13] A DWI study of chronic TBI patients demonstrated increased mean ADC values in both visible lesions and normal-appearing tissue in the corpus callosum. 14 This finding corresponds to the increased MD observed in later DTI studies 5,15,16 and such changes in indices of diffusion are considered to reflect pathology in microstructure and architectural organization. 9 Some longitudinal studies have examined how changes in white matter diffusion properties evolve in the corpus callosum from the early to the chronic phase after TBI.…”

Section: Introductionsupporting

confidence: 59%

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

Moen

Håberg

Skandsen

et al. 2014

Journal of Neurotrauma

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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.

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Section: Mean Adc Values and Comparison With Controlssupporting

confidence: 87%

Section: Introductionsupporting

confidence: 59%

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

Moen

Håberg

Skandsen

et al. 2014

Journal of Neurotrauma

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“…One measured diffusion anisotropy of the corpus callosum (splenium, body, genu) in 10 patients 2 weeks to 8 months after TBI (initial GCS scores ranged from 3 to 14) compared to normal individuals. 29 Diffusion anisotropy was decreased by an average of approximately 25% in at least one region of the corpus callosum in all 10 patients, indicating disruption of the normally highly ordered structure. Decreased anisotropy was found even in areas that looked normal on both FLAIR and GE images.…”

Section: Imaging Studiesmentioning

confidence: 87%

Traumatic Axonal Injury: Novel Insights Into Evolution and Identification

Hurley¹,

McGowan²,

Arfanakis³

et al. 2004

JNP

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Cover. (Bottom) An axial contour map (irregular green lines) of areas that are more than 2 standard deviations below normal white matter magnetization transfer ratio in the region of the splenium of the corpus callosum in a patient with traumatic brain injury. (Top) The approximate axial section is indicated (straight green line) on a normal sagittal T1 weighted magnetic resonance (MR) scan. Figure 1. Axial Diffusion TensorImaging. An area with vasogenic edema is visible in the left frontal lobe on the T2 weighted image (arrows). It is much less evident on the mean diffusion-weighted map of the same section, produced by averaging the diffusion-weighted images obtained in all 23 noncolinear directions of the diffusion gradients. The corresponding trace map shows increased diffusivity in the left frontal lobe (arrows). In the fractional anisotropy map of the same section decreased anisotropy is visible in the left anterior portion of the corpus callosum due to the presence of vasogenic edema (arrowhead). Diffusion anisotropy is also decreased in the anterior portion of the left internal and external capsules (arrow), although these regions are characterized by normal T2 and trace values. A box indicates the region of the spenium of the corpus callosum in which a detailed analysis was performed by overlaying contours that correspond to 2 standard deviations (SD) below normal white matter magnetization transfer ratio (MTR). Arrows indicate regions in which the MTR was more than 2 SD below normal in these two traumatic brain injury (TBI) cases. Both patients had cognitive impairments consistent with TBI.

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“…The TCI method is simple and objective and requires little cooperation from the patient; hence, this method has the advantage of excluding any cognitive impairment when the severity of the TBI was evaluated. To our knowledge, imaging was the only available technique that could evaluate the severity of DAI while the patient was alive [9,12,14]. Therefore, TCI may be a unique diagnostic tool for electrophysiologically evaluating the DAI by monitoring the CC lesions.…”

Section: Introductionmentioning

confidence: 99%

Measurement of transcallosal inhibition in traumatic brain injury by transcranial magnetic stimulation

Takeuchi¹,

Ikoma²,

Chuma³

et al. 2006

Brain Injury

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Primary objective: To study whether transcallosal inihibition (TCI) can evaluate the severity of traumatic brain injury (TBI).Research design: Case-control study. Methods and procedures:We studied 20 patients with a chronic TBI and 20 control subjects. We checked following transcranial magnetic stimulation parameters; resting motor threshold, central motor latency times, onset latency of TCI, duration of TCI, transcallosal conduction times and amount of TCI. We evaluated the severity of TBI using Glasgow Coma Scale (GCS). Main outcome and results:The amount of TCI was significantly lower in the patients than the control subjects (p <0.001). The amount of TCI was highly correlated with the GCS (r = 0.787, p < 0.001).Conclusion: An assessment of TCI was found to be a more sensitive and useful methods for an evaluation of the severity of TBI.

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Diffuse axonal injury: detection of changes in anisotropy of water diffusion by diffusion-weighted imaging

Cited by 56 publications

References 20 publications

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

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

Traumatic Axonal Injury: Novel Insights Into Evolution and Identification

Measurement of transcallosal inhibition in traumatic brain injury by transcranial magnetic stimulation

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