T₁ and T₂ quantification using magnetic resonance fingerprinting in mild traumatic brain injury

To assess whether MR fingerprinting (MRF)-based relaxation properties exhibit cross-sectional and prospective correlations with patient outcome and compare the results with those from DTI.

Clinical imaging, MRF, and DTI were acquired in patients (24 ± 10 days after injury (timepoint 1) and 90 ± 17 days after injury (timepoint 2)) and once in controls. Patient outcome was assessed with global functioning, symptom profile, and neuropsychological testing. ADC and fractional anisotropy (FA) from DTI and T₁ and T₂ from MRF were compared in 12 gray and white matter regions with Mann-Whitney tests. Bivariate associations between MR measures and outcome were assessed using the Spearman correlation and logistic regression.

Data from 22 patients (38 ± 12 years; 17 women) and 18 controls (32 ± 8 years; 12 women) were analyzed. Fourteen patients (37 ± 12 years; 11 women) returned for timepoint 2, while two patients provided only timepoint 2 clinical outcome data. At timepoint 1, there were no differences between patients and controls in T₁, T₂, and ADC, while FA was lower in mTBI frontal white matter. T₁ at timepoint 1 and the change in T₁ exhibited more (n = 18) moderate to strong correlations (|r|= 0.6-0.85) with clinical outcome at timepoint 2 than T₂ (n = 3), FA (n = 7), and ADC (n = 2). High T₁ at timepoint 1, and serially increasing T₁, accounted for five of the six MR measures with the highest utility for identification of non-recovered patients at timepoint 2 (AUC > 0.80).

T₁ derived from MRF was found to have higher utility than T₂, FA, and ADC for predicting 3-month outcome after mTBI.

• In a region-of-interest approach, FA, ADC, and T₁ and T₂ all showed limited utility in differentiating patients from controls at an average of 24 and 90 days post-mild traumatic brain injury. • T₁ at 24 days, and the serial change in T₁, revealed more and stronger predictive correlations with clinical outcome at 90 days than did T₂, ADC, or FA. • T₁ showed better prospective identification of non-recovered patients at 90 days than ADC, T₂, and FA.