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
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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.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Traumatic brain injury, Long-term diffusion tensor imaging, Brain atrophy, GOS-E, Mean diffusivity
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Vol 64 - N° 2
Articolo 101433- marzo 2021 Ritorno al numero
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