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Advanced Diffusion Imaging in The Hippocampus of Rats with Mild Traumatic Brain Injury
Published on: August 14, 2019
Diffusion tensor MR imaging in pediatric head trauma
Erhan Akpinar1, Mert Koroglu, Thomas Ptak
1Division of Emergency Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Insights
Fractional anisotropy (FA) MRI detects abnormalities in pediatric head trauma, even with normal brain scans. Lower FA values correlate with injury severity and longer hospital stays, suggesting FA as a potential biomarker.
Area of Science:
- Neuroimaging
- Pediatric Neurology
- Radiology
Background:
- Pediatric head trauma can cause subtle white matter damage not always visible on standard MRI.
- Fractional anisotropy (FA) derived from diffusion tensor imaging (DTI) is sensitive to white matter microstructural integrity.
- Understanding FA changes in pediatric head trauma is crucial for assessing injury severity and prognosis.
Purpose of the Study:
- To investigate fractional anisotropy (FA) values in pediatric patients with closed head trauma.
- To correlate FA values with the initial Glasgow Coma Scale (GCS) score.
- To explore the relationship between FA values, MRI findings, and clinical outcomes.
Main Methods:
- Retrospective analysis of 24 pediatric patients with closed head trauma and 22 age-matched controls.
- All patients underwent head CT and cerebral MRI with diffusion tensor imaging (DTI).
- FA measurements were obtained from 6 major white matter regions; GCS and hospital stay data were collected.
Main Results:
- Significant differences in mean FA values were observed between trauma and control groups, particularly in the corpus callosum.
- Pediatric head trauma patients with lower GCS scores (<10) and positive MRI findings exhibited reduced FA values.
- A negative correlation was found between FA values and length of hospital stay, indicating poorer outcomes with lower FA.
Conclusions:
- MRI diffusion FA measurements can reveal abnormalities in pediatric head trauma, even when conventional MRI appears normal.
- FA values show potential as a sensitive biomarker for injury severity and prognosis in pediatric head trauma.
- Larger studies are needed to confirm these findings and establish the stability of FA correlations.
Purpose:
We propose to investigate the fractional anisotropy (FA) values in pediatric patients with closed head trauma and correlate them with the initial Glasgow Coma Scale (GCS).
Materials And Methods:
A retrospective evaluation of 24 pediatric patients (15 men, 9 women; mean age, 13 years; range, 2-18 years) who underwent both unenhanced head computed tomography and cerebral magnetic resonance imaging (MRI), including the tensor diffusion sequence, within 30 days of the incident. Twenty-two atraumatic control patients (9 men, 13 women; mean age, 9 years; range, 4-17 years) were randomly selected from the records of the radiology department within the same period. Fractional anisotropy measurements were taken from each of 6 major white matter volumes. Data extracted from the record of each subject included GCS, initial head computed tomographic results, and length of hospital stay. Kruskal-Wallis and t tests were used for statistical evaluation.
Results:
The mean acute score on the GCS was 9.7 +/- 5. Mean duration of hospitalization days was 8.7 +/- 10. Statistically significant differences in mean FA values between trauma and control subjects were noted in corpus callosum. Trauma patients with positive findings on MRI and with GCS less than 10 also had lower FA values than patients with GCS greater than 10 and patients who had normal MRI findings. There was a negative correlation between time to discharge and FA values.
Conclusions:
In pediatric head trauma, MRI diffusion FA measurements can show abnormalities despite normal-appearing brain MRI findings. Larger investigations are required to verify the stability of correlations.
