Role of diffusion-weighted magnetic resonance imaging in diffuse axonal injury

Ezaki, Yasuyuki; Tsutsumi, Keisuke; Morikawa, Minoru; Nagata, Izumi

doi:10.1080/02841850600771486

Cited by 64 publications

(38 citation statements)

References 23 publications

(24 reference statements)

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“…According to Oehmichen et al, 42 localized axonal injury was regularly present in the brains of shaken baby syndrome infants surviving longer than 1.5 to 3.0 hours, but only occasionally in the craniocervical junction. Ezaki et al 43 stated that diffusion-weighted imaging cannot detect all DAI-related lesions but is a potentially useful imaging modality for both diagnosing and assessing patients with DAI.…”

Section: Discussionmentioning

confidence: 99%

Deep Into the Fibers! Postmortem Diffusion Tensor Imaging in Forensic Radiology

Flach

Schroth

Schweitzer

et al. 2015

American Journal of Forensic Medicine &Amp; Pathology

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Purpose: In traumatic brain injury, diffusion-weighted and diffusion tensor imaging of the brain are essential techniques for determining the pathology sustained and the outcome. Postmortem cross-sectional imaging is an established adjunct to forensic autopsy in death investigation. The purpose of this prospective study was to evaluate postmortem diffusion tensor imaging in forensics for its feasibility, influencing factors and correlation to the cause of death compared with autopsy.Methods: Postmortem computed tomography, magnetic resonance imaging, and diffusion tensor imaging with fiber tracking were performed in 10 deceased subjects. The Likert scale grading of colored fractional anisotropy maps was correlated to the body temperature and intracranial pathology to assess the diagnostic feasibility of postmortem diffusion tensor imaging and fiber tracking.Results: Optimal fiber tracking (>15,000 fiber tracts) was achieved with a body temperature at 10°C. Likert scale grading showed no linear correlation (P > 0.7) to fiber tract counts. No statistically significant correlation between total fiber count and postmortem interval could be observed (P = 0.122). Postmortem diffusion tensor imaging and fiber tracking allowed for radiological diagnosis in cases with shearing injuries but was impaired in cases with pneumencephalon and intracerebral mass hemorrhage.Conclusions: Postmortem diffusion tensor imaging with fiber tracking provides an exceptional in situ insight "deep into the fibers" of the brain with diagnostic benefit in traumatic brain injury and axonal injuries in the assessment of the underlying cause of death, considering influencing factors for optimal imaging technique.

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Section: Discussionmentioning

confidence: 99%

Deep Into the Fibers! Postmortem Diffusion Tensor Imaging in Forensic Radiology

Flach

Schroth

Schweitzer

et al. 2015

American Journal of Forensic Medicine &Amp; Pathology

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“…Thus, there is a need for more sensitive imaging techniques. Several studies have demonstrated the value of diffusion-weighted imaging (DWI) in the evaluation of TAI and other traumatic lesions in the acute stage [2,9,13,14,20,22,30]. In addition to improved lesion detection and characterization DWI could possibly provide clinically relevant quantitative data of traumatic tissue changes away from the visible lesions.…”

Section: Introductionmentioning

confidence: 99%

Diffusivity of Normal-Appearing Tissue in Acute Traumatic Brain Injury

et al. 2011

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“…Studies over the years have advocated different imaging methods to improve identification of DAI-beginning with the standard computed tomography (CT), and moving to general magnetic resonance imaging, or MRI (e.g., Parizel et al, 1998;Tomaiuolo et al, 2005), special sequences of MRI (Takaoka et al, 2002), and finally Diffusion Tensor Imaging (DTI, Ezaki, Tsutsumi, Morikawa, & Nagata, 2006). Each imaging method has been beneficial in improving the number of cases of DAI diagnosed clinically, but still the only definitive diagnostic for DAI is microscopic (Kraus, Susmaras, Caughlin, Walker, Sweeney, & Little, 2007), and autopsy studies in TBI have suggested that DAI is massively underdiagnosed.…”

Section: Diffuse Axonal Injury and Secondary Mechanismsmentioning

confidence: 99%