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Updated: Jul 20, 2026
Advanced Diffusion Imaging in The Hippocampus of Rats with Mild Traumatic Brain Injury
Published on: August 14, 2019
Use of advanced neuroimaging techniques in the evaluation of pediatric traumatic brain injury
Stephen Ashwal1, Barbara A Holshouser, Karen A Tong
1Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA. sashwal@ahs.llumc.edu
Insights
Advanced neuroimaging, including susceptibility weighted imaging and diffusion tensor imaging, detects subtle brain injuries in children. These techniques reveal damage not visible with conventional methods, improving diagnosis and treatment for traumatic brain injury.
Area of Science:
- Pediatric neuroimaging
- Traumatic brain injury (TBI) research
- Advanced magnetic resonance imaging (MRI)
Background:
- Traumatic brain injury (TBI) in children requires sensitive diagnostic tools.
- Conventional imaging may miss subtle or diffuse injuries.
- Neuroimaging advancements offer new insights into pediatric TBI.
Purpose of the Study:
- To review advanced neuroimaging techniques for acute pediatric TBI.
- To highlight the application of four specific MRI methods.
- To emphasize the detection of non-apparent injuries.
Main Methods:
- Susceptibility weighted imaging (SWI) for hemorrhagic lesions.
- Magnetic resonance spectroscopy (MRS) for neurochemical alterations.
- Diffusion weighted imaging (DWI) for ischemic injury.
- Diffusion tensor imaging (DTI) for white matter tract evaluation.
Main Results:
- SWI enhances detection of hemorrhagic lesions, often linked to diffuse axonal injury (DAI).
- MRS provides noninvasive assessment of neurochemical changes for early prognosis.
- DWI is sensitive for early detection of ischemic injury post-TBI.
- DTI effectively identifies white matter abnormalities in DAI cases where conventional imaging is normal.
Conclusions:
- Advanced MRI techniques reveal significant injury in 'normal-appearing' pediatric brains.
- These methods improve the understanding of TBI's underlying pathology.
- Integration of these techniques can enhance pediatric TBI treatment and change the standard of care.
Abstract:
Advanced neuroimaging techniques are now used to expand our knowledge of traumatic brain injury, and increasingly, they are being applied to children. This review will examine four of these methods as they apply to children who present acutely after injury. (1) Susceptibility weighted imaging is a 3-dimensional high-resolution magnetic resonance imaging technique that is more sensitive than conventional imaging in detecting hemorrhagic lesions that are often associated with diffuse axonal injury. (2) Magnetic resonance spectroscopy acquires metabolite information reflecting neuronal integrity and function from multiple brain regions and provides sensitive, noninvasive assessment of neurochemical alterations that offers early prognostic information regarding the outcome. (3) Diffusion weighted imaging is based on differences in diffusion of water molecules within the brain and has been shown to be very sensitive in the early detection of ischemic injury. It is now being used to study the direct effects of traumatic injury as well as those due to secondary ischemia. (4) Diffusion tensor imaging is a form of diffusion weighted imaging and allows better evaluation of white matter fiber tracts by taking advantage of the intrinsic directionality (anisotropy) of water diffusion in human brain. It has been shown to be useful in identifying white matter abnormalities after diffuse axonal injury when conventional imaging appears normal. An important aspect of these advanced methods is that they demonstrate that 'normal-appearing' brain in many instances is not normal, i.e. there is evidence of significant undetected injury that may underlie a child's clinical status. Availability and integration of these advanced imaging methods will lead to better treatment and change the standard of care for use of neuroimaging to evaluate children with traumatic brain injury.
