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Magnetic resonance imaging of traumatic brain injury: relationship of T2*SE and T2GE to clinical severity and outcome.
Gerber, Donald J; Weintraub, Alan H; Cusick, Christopher P; Ricci, Peter E; Whiteneck, Gale G.
Afiliação
  • Gerber DJ; Craig Hospital, Englewood, CO 80113, USA. dgerber@craighospital.cor
Brain Inj ; 18(11): 1083-97, 2004 Nov.
Article em En | MEDLINE | ID: mdl-15545206
ABSTRACT
PRIMARY

OBJECTIVES:

To evaluate (1) the sensitivity of magnetic resonance imaging (MRI) T2* weighted gradient echo (GE) vs T2 weighted spin echo (SE) technology for lesion detection in traumatic brain injury (TBI) and (2) the relationship of lesion patterns to acute clinical severity and 1 year post-injury outcome measures. RESEARCH

DESIGN:

Comparative analysis. METHODS AND PROCEDURES Forty-three acute rehabilitation patients with TBI were imaged utilizing T2 SE and T2* GE techniques an average of 26 days post-injury. Acute clinical severity measures, including Glasgow Coma Scale (GCS), time to follow commands (TFC) and post-traumatic amnesia (PTA) were abstracted from medical records. One-year post-injury outcome measures including Glasgow Outcome Scale (GOS), Disability Rating Scale (DRS) and the Craig Handicap Assessment and Reporting Technique--Short Form (CHART-SF) were collected as part of a comprehensive annual follow-up. MAIN OUTCOMES AND

RESULTS:

In comparison to T2 SE, T2* GE more frequently detected lesions in each of the cortical (p <0.0001), white matter (p <0.001), central grey (p <0.001) and brainstem (p <0.01) regions and in each of the frontal (p <0.0001), temporal (p <0.0001), parietal (p <0.001) and occipital (p <0.0001) lobes. With regards to acute clinical severity measures, T2* GE findings were the best predictors of GCS and the only significant predictors of PTA, while T2 SE findings were better predictors of TFC. For 1 year post-injury outcome measures, multivariate regression models utilizing T2 SE and T2* GE findings in combination were the best predictors of DRS and GOS and T2 SE findings alone were the best predictors of CHART-SF.

CONCLUSIONS:

This study demonstrates the enhanced sensitivity of T2* GE for detecting haemorrhagic lesions associated with TBI and supports a complimentary role for both T2 SE and T2* GE weighted imaging in characterizing injury severity and predicting longer-term outcomes.
Assuntos
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Base de dados: MEDLINE Assunto principal: Lesões Encefálicas / Imageamento por Ressonância Magnética Tipo de estudo: Diagnostic_studies / Evaluation_studies / Prognostic_studies Limite: Adolescent / Adult / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2004 Tipo de documento: Article
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Base de dados: MEDLINE Assunto principal: Lesões Encefálicas / Imageamento por Ressonância Magnética Tipo de estudo: Diagnostic_studies / Evaluation_studies / Prognostic_studies Limite: Adolescent / Adult / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2004 Tipo de documento: Article