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Published on: August 14, 2019
Conspicuity of diffuse axonal injury lesions on diffusion-weighted MR imaging
Toshibumi Kinoshita1, Toshio Moritani, Akio Hiwatashi
1Department of Radiology, Division of Neuroradiology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY 14642, USA. kino@grape.med.tottori-u.ac.jp
Objective:
(1) To detect diffuse axonal injury (DAI) lesions by diffusion-weighted imaging (DWI), as compared with fluid-attenuated inversion recovery (FLAIR) imaging and (2) to evaluate hemorrhagic DAI lesions by b0 images obtained from DWI, as compared with gradient-echo (GRE) imaging.
Methods:
We reviewed MR images of 36 patients with a diagnosis of DAI. MR imaging was performed 20 h to 14 days (mean, 3.7 days) after traumatic brain injury. We evaluated: (1) conspicuity of lesions on DWI and FLAIR and (2) conspicuity of hemorrhage in DAI lesions on b0 images and GRE imaging.
Results:
DWI clearly depicted high-signal DAI lesions. The sensitivity of DWI to lesional conspicuity in DAI lesions was almost equal to that of FLAIR. The sensitivity of b0 images to identification of hemorrhagic DAI lesions was inferior to that of GRE.
Conclusion:
DWI is as useful as FLAIR in detecting DAI lesions. GRE imaging is still the superior tool for the evaluation of hemorrhagic DAI.
Insights
Diffusion-weighted imaging (DWI) effectively detects diffuse axonal injury (DAI) lesions, performing comparably to FLAIR imaging. However, gradient-echo (GRE) imaging remains superior for identifying hemorrhagic DAI lesions compared to DWI b0 images.
Area of Science:
- Neuroradiology
- Neuroimaging
- Traumatic Brain Injury
Background:
- Diffuse axonal injury (DAI) is a common and severe consequence of traumatic brain injury.
- Accurate detection of DAI lesions is crucial for diagnosis and management.
- Advanced MRI techniques are continuously evaluated for improved sensitivity and specificity.
Purpose of the Study:
- To compare the efficacy of diffusion-weighted imaging (DWI) with fluid-attenuated inversion recovery (FLAIR) in detecting DAI lesions.
- To assess the utility of DWI b0 images versus gradient-echo (GRE) imaging for identifying hemorrhagic DAI lesions.
Main Methods:
- Retrospective review of MR images from 36 patients diagnosed with DAI.
- Evaluation of lesion conspicuity on DWI and FLAIR sequences.
- Assessment of hemorrhage conspicuity on DWI b0 images and GRE imaging.
Main Results:
- DWI demonstrated high-signal intensity in DAI lesions, with sensitivity nearly equivalent to FLAIR.
- GRE imaging showed superior sensitivity in identifying hemorrhagic DAI lesions compared to DWI b0 images.
Conclusions:
- DWI is a valuable tool for detecting DAI lesions, offering comparable performance to FLAIR.
- GRE imaging remains the preferred method for evaluating hemorrhagic DAI due to its higher sensitivity.
