Application of diffusion tensor imaging combined with magnetic resonance spectroscopy in prognostic assessment of comatose patients with traumatic brain injury(PDF)
《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]
- Issue:
- 2019年第4期
- Page:
- 447-452
- Research Field:
- 医学影像物理
- Publishing date:
Info
- Title:
- Application of diffusion tensor imaging combined with magnetic resonance spectroscopy in prognostic assessment of comatose patients with traumatic brain injury
- Author(s):
- ZHANG Xiaofeng; ZHANG Mingwen; YU Zhihu; ZHU Lin; ZHOU Yanling
- Department of Neurosurgery, Xiaolan Hospital Affiliated to Southern Medical University, Zhongshan 528415, China
- Keywords:
- ; Keywords: traumatic brain injury; coma; diffusion tensor imaging; magnetic resonance spectroscopy; diffusion coefficient
- PACS:
- R651.1
- DOI:
- DOI:10.3969/j.issn.1005-202X.2019.04.015
- Abstract:
- Abstract: Objective To analyze the changes of diffusion tensor imaging (DTI) and magnetic resonance spectroscopy (MRS) in comatose patients with traumatic brain injury (TBI) at different stages for evaluating the correlations between the related parameters and coma recovery scale-revised score or the modified Glasgow outcome score, and exploring the application value of the combination of DTI and MRS in TBI prognostic assessment. Methods Ten TBI patients and 10 normal controls were scanned with magnetic resonance imaging, DTI and MRS. The related DTI parameters (fractional anisotropy, mean diffusivity, axial diffusivity and radial diffusivity) of the thalamus (intralaminar nucleus, reticular nucleus) and brain regions related to ascending reticular activating system (pons, medulla) in normal controls and comatose patients with TBI in the acute stage (from 2 to 3 weeks) and the chronic stage (more than 4 weeks) were measured. Moreover, the acetyl aspartate, choline, creatinine and lactic acid were determined with MRS. The differences between normal controls and TBI patients were analyzed with independent sample t-test and the differences between the chronic stage and the acute stage were analyzed with paired t-test. Moreover, a correlation analysis was performed on the related parameters and coma recovery scale-revised score or the modified Glasgow outcome score. Results The DTI and MRS parameters of TBI patients were significantly different from those of normal controls. DTI and MRS in the chronic stage achieved a better assessment of the prognosis of TBI patients. The parameters in the ascending reticular activating system recovered more slowly than those in the thalamus. The prognosis of TBI patients was better predicted by axial diffusivity and radial diffusivity. Conclusion The prognosis of comatose patients with TBI can be predicted by the analysis on intracerebral DTI and MRS, so as to guide the treatment.
Last Update: 2019-04-23