Global mean diffusivity: A radiomarker discriminating good outcome long term after traumatic brain injury - 24/03/21
, Vincent Perlbarg c, d, Alice Jacquens e, f, Mélanie Pélégrini-Issac d, Marion Bisch e, Amélie Prigent e, Blandine Lesimple e, Elsa Caron a, Muriel Lefort d, Eléonore Bayen a, b, Damien Galanaud d, g, Pascale Pradat-Diehl a, b, d, Louis Puybasset d, e, Vincent Degos e, f
Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.
Connectez-vous pour en bénéficier!
Highlights |
• | Anatomical lesions caused by traumatic brain injury (TBI) are probably associated with global outcome, long term after injury. |
• | The best radiological parameter to measure lesions more than 2 years after TBI is not well defined. |
• | Global mean diffusivity measured by diffusion tensor MRI could discriminate patients with good recovery from others, at long term after severe TBI. |
Abstract |
Background |
Traumatic brain injury (TBI) is a chronic pathology responsible for cognitive disorders impacting outcome. Global clinical outcome several years after TBI may be associated with anatomical sequelae. Anatomical lesions are not well described because characterizing diffuse axonal injury and brain atrophy require using specific MRI sequences with quantitative measures. The best radiologic parameter to describe the lesions long term after TBI is not known.
Objective |
We aimed to first, assess the global volumetric and diffusion parameters related to long-term outcome after TBI and second, define the most discriminating parameter.
Methods |
In this observational study, we included 96 patients with severe TBI and 22 healthy volunteers. The mean delay after TBI was 63.2 months [range 31–119]. The Glasgow Outcome Scale Extended (GOS-E) was used to assess the global long-term clinical outcome. All patients underwent multimodal MRI with measures of brain volume, ventricle volume, global fractional anisotropy (FA) and global mean diffusivity (MD).
Results |
All 96 participants had significant impairment in global FA, global MD, brain volume and ventricle volume as compared with the 22 controls (P<0.01). Only global MD significantly differed between the “good recovery” group (GOS-E score 7-8) and the other two groups: GOS-E scores 3-4 and 5-6. Brain volume significantly differed between the GOS-E 7-8 and 3-4 groups. Global MD was the most discriminating radiological parameter for the “good recovery” group versus other patients, long term after TBI. FA appeared less relevant at this time. Global atrophy was higher in patients than controls but lacked reliability to discriminate groups of patients.
Conclusion |
Global mean diffusivity seems a more promising radiomarker than global FA for discriminating good outcome long term after TBI. Further work is needed to understand the evolution of these long-term radiological parameters after TBI.
Le texte complet de cet article est disponible en PDF.Keywords : Traumatic brain injury, Long-term diffusion tensor imaging, Brain atrophy, GOS-E, Mean diffusivity
Plan
Vol 64 - N° 2
Article 101433- mars 2021 Retour au numéro
Article précédent
- In peripheral artery disease, diabetes is associated with reduced physical activity level and physical function and impaired cardiac autonomic control: A cross-sectional study
- Marilia Almeida Correia, Gustavo Oliveira Silva, Paulo Longano, Ivani Credidio Trombetta, Fernanda Consolim-Colombo, Pedro Puech-Leão, Nelson Wolosker, Gabriel Grizzo Cucato, Raphael Mendes Ritti-Dias
- Cardiorespiratory mechanisms underlying the impaired oxygen uptake kinetics at exercise onset after stroke
- Kazuaki Oyake, Yasuto Baba, Yuki Suda, Jun Murayama, Ayumi Mochida, Kunitsugu Kondo, Yohei Otaka, Komito Momose
Bienvenue sur EM-consulte, la référence des professionnels de santé.