Diffusion-Weighted Imaging for the Evaluation of Diffuse Axonal Injury in Closed Head Injury

Huisman, Thierry A. G. M.; Sorensen, A. Gregory; Hergan, Klaus; González, Ramón; Schaefer, Pamela W.

doi:10.1097/00004728-200301000-00002

Cited by 226 publications

(137 citation statements)

References 19 publications

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“…The typical diffusion times used for clinical DWI are 10 -50 ms, corresponding to average molecular displacements on the order of 10 m. This microscopic spatial scale is in the same range as that of cellular dimensions. This sensitivity to cellular processes has been exploited clinically for improving the detection of acute cerebral ischemia, 4,6-10 distinguishing vasogenic from cytotoxic edema, [11][12][13][14][15][16] identifying foci of axonal shearing injury after acute head trauma, [17][18][19] characterizing cellularity in brain tumors, [20][21][22][23][24][25][26][27] discriminating between metastases and gliomas 22,27 and between tumor recurrence and postsurgical injury, 28 differentiating pyogenic abscesses from tumors, [29][30][31] and for the noninvasive mapping of white matter connectivity by using the diffusion tensor model, [32][33][34][35][36] among other applications.…”

Section: Theoretic Underpinnings Of Diffusion Imagingmentioning

confidence: 99%

Diffusion Tensor MR Imaging and Fiber Tractography: Theoretic Underpinnings

Mukherjee¹,

Berman²,

Chung³

et al. 2008

AJNR Am J Neuroradiol

430

312

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SUMMARY:In this article, the underlying theory of clinical diffusion MR imaging, including diffusion tensor imaging (DTI) and fiber tractography, is reviewed. First, a brief explanation of the basic physics of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) mapping is provided. This is followed by an overview of the additional information that can be derived from the diffusion tensor, including diffusion anisotropy, color-encoded fiber orientation maps, and 3D fiber tractography. This article provides the requisite background for the second article in this 2-part review to appear next month, which covers the major technical factors that affect image quality in diffusion MR imaging, including the acquisition sequence, magnet field strength, gradient amplitude and slew rate, and multichannel radio-frequency coils and parallel imaging. The emphasis is on optimizing these factors for state-of-the-art DWI and DTI based on the best available evidence in the literature. Diffusion MR imaging of the brain was first adopted for use in clinical neuroradiology during the early 1990s and was found to have immediate utility for the evaluation of suspected acute ischemic stroke. Since that time, enormous strides forward in the technology of diffusion imaging have greatly improved image quality and enabled many new clinical applications. These include the diagnosis of intracranial pyogenic infections, masses, trauma, and vasogenic-versus-cytotoxic edema. Furthermore, the advent of diffusion tensor imaging (DTI) and fiber tractography has opened an entirely new noninvasive window on the white matter connectivity of the human brain. DTI and fiber tractography have already advanced the scientific understanding of many neurologic and psychiatric disorders and have been applied clinically for the presurgical mapping of eloquent white matter tracts before intracranial mass resections.This 2-part review explores the current state of the art for the acquisition and analysis of clinical diffusion imaging, including DTI and fiber tractography. This first article begins with an explanation of the basic physics and underlying theory of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) mapping. This is followed by an overview of the additional information that can be derived from the diffusion tensor, including diffusion anisotropy, color-encoded fiber-orientation maps, and 3D fiber tractography. This article provides the necessary background for the second article, which focuses on the major technical factors that affect image quality in diffusion imaging, with an emphasis on optimizing these factors for state-of-the-art DWI and DTI based on the best available evidence in the literature. Theoretic Underpinnings of Diffusion ImagingBrownian Motion and Tissue Ultrastructure Diffusion, also known as "Brownian motion," refers to constant random microscopic molecular motion due to heat. At a fixed temperature, the rate of diffusion can be described by the Einstein equation 1 :where Ͻr 2 Ͼ refers...

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Section: Theoretic Underpinnings Of Diffusion Imagingmentioning

confidence: 99%

Diffusion Tensor MR Imaging and Fiber Tractography: Theoretic Underpinnings

Mukherjee¹,

Berman²,

Chung³

et al. 2008

AJNR Am J Neuroradiol

430

312

View full text Add to dashboard Cite

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“…4,7,28 Light microscopic studies have shown that the density of thin diameter fibers reach a minimum and large myelinated fibers reach a maximum in the posterior truncus. 29,30 Increased ADC values could result from loss of myelin sheaths, a phenomenon that neuropathological review examinations have found to continue for 1-2 years post-injury.…”

Section: Neuropathological Origin Of Increased Adc Values In Differenmentioning

confidence: 99%

“…The application of diffusion weighted imaging (DWI) or diffusion tensor imaging (DTI) has yielded increased sensitivity in the detection of TAI. 2,7 DWI is based on the random movements of water molecules in the tissue known as ''Brownian motions.'' The rate of net diffusion of molecules is referred to as the ''apparent diffusion coefficient'' (ADC) value.…”

Section: Introductionmentioning

confidence: 99%

“…In human studies from the early phase after TBI, mostly decreased ADC values have been observed in visible DWI white matter lesions, 7,10 whereas increased mean ADC values have been reported in normal-appearing tissue. [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.…”

Section: Introductionmentioning

confidence: 99%

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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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“…Fractional anisotropy (FA) is sensitive to changes in white matter integrity (Watts et al, 2003). FA loss and D av rise have been demonstrated in a number of traumatic brain injury (TBI) studies (Huisman et al 2004;Lee, et al, 2003;Huisman et al 2003;Arfanakis, 2002). It is reasonable to assume that these quantitative characteristics are indicative of white matter damage in a variety of pathologies.…”

Section: Introductionmentioning

confidence: 99%

Diffusion tensor imaging segmentation of white matter structures using a Reproducible Objective Quantification Scheme (ROQS)

2007

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Reproducible Objective Quantification Scheme (ROQS) is a novel method for regional white matter measurements of diffusion tensor imaging (DTI) parameters that overcomes the limitations of previous approaches for analyzing large cohorts of subjects reliably. ROQS is a semi-automated technique that exploits the fiber orientation information from the diffusion tensor in conjunction with a binary masking and chain-linking algorithm to segment anatomically distinct white matter tracts for subsequent quantitative analysis of DTI parameters such as fractional anisotropy and apparent diffusion coefficient. When applied to 3 Tesla whole-brain DTI of normal adult volunteers, ROQS is shown to segment the corpus callosum much faster than manual region of interest (ROI) delineation, and with better reproducibility and accuracy.

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Diffusion-Weighted Imaging for the Evaluation of Diffuse Axonal Injury in Closed Head Injury

Cited by 226 publications

References 19 publications

Diffusion Tensor MR Imaging and Fiber Tractography: Theoretic Underpinnings

Diffusion Tensor MR Imaging and Fiber Tractography: Theoretic Underpinnings

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

Diffusion tensor imaging segmentation of white matter structures using a Reproducible Objective Quantification Scheme (ROQS)

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