gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Detection of axonal injury by Diffusion and T2*-weighted MR Imaging in patients with traumatic brain injury

Diagnostik der axonalen Scherverletzung bei Patienten mit Schädel-Hirntrauma: Diffusionwichtung und T2*-gradienten Echosequenzen

Meeting Abstract

  • corresponding author Matthias Setzer - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main
  • S. Weidauer - Institut für Neuroradiologie, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main
  • M. Zimmermann - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main
  • E. J. Hermann - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main
  • G. Marquardt - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main
  • V. Seifert - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMO.11.05

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2004/04dgnc0111.shtml

Veröffentlicht: 23. April 2004

© 2004 Setzer et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Axonal injury is a well known sequelae of traumatic brain injury. This study was performed to identify the different types and patterns of brain tissue injury and to determine the prognostic significance of this lesions by diffusion-weighted imaging (DWI) in patients with severe traumatic brain injury.

Methods

Twenty nine consecutive patients with severe traumatic brain injury who fulfilled the criteria of prolonged coma or indications of shear injury in early CT scans were included in this study. MR examinations were performed according to standard departmental protocols. Conventional MRI included the following sequences: T1 with and without contrast enhancement and T2-weighted imaging. Additionally T2* GRE imaging and full diffusion tensor imaging was used. Signal abnormalities in every sequence were assessed with respect to location and extent semiquantitatively. Additionally all patients underwent a follow-up examination. The mean follow-up was 18,2 ± 12,4 months (range 4 - 36 months). The patients were assessed according to the Glasgow Outcome Scale (GOS), Rankin Scale (RS) and Karnofsky Performance Score (KPS). Differences between groups were compared using the H-Test of Kruskal and Wallis.

Results

Two general injury patterns were observed: 1. an injury pattern with signal abnormalities in T2* sequences and 2. an injury pattern with signal abnormalities in DWI sequences. In the patient collective (n=29) 4 patient groups could be identified: Group1: T2* signal abnormalities and normal DWI (n=3); Group 2: DWI signal abnormalities and normal T2* (n=3); Group 3: both T2* and DWI signal abnormalities (n=14); Group 4: Normal T2* and DWI sequences (n=9). Differences in outcome between the 4 patient groups were significant (p<0,05), with the worst outcome in group 3 and the best in group 4. In addition patient outcome was influenced significantly by the location and extent of signal abnormalities in both T2* and DWI sequences.

Conclusions

1. In patients with severe traumatic brain injury two injury patterns can be differentiated by means of MRI including DWI and T2*. 2. Quality, extent and location of signal abnormalities are of significant importance for the outcome of patients with severe traumatic brain injury.