Magnetization transfer imaging and proton MR spectroscopy in the evaluation of axonal injury: Correlation with clinical outcome after traumatic brain injury

G. Sinson, L. J. Bagley, K. M. Cecil, M. Torchia, J. C. McGowan, R. E. Lenkinski, T. K. McIntosh, R. I. Grossman

Research output: Contribution to journalArticle

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Abstract

BACKGROUND AND PURPOSE: Current imaging does not permit quantification of neural injury after traumatic brain injury (TBI) and therefore limits both the development of new treatments and the appropriate counseling of patients concerning prognosis. We evaluated the utility of magnetization transfer ratio (MTR) and proton MR spectroscopy in identifying patients with neuronal injury after TBI. METHODS: Thirty patients with TBI (21-77 years old; mean age, 42 years; admission Glasgow Coma Scale (GOS) scores 3-15; mean score, 11) were studied on a 1.5-T system with magnetization transfer imaging and MR spectroscopy of the splenium. Magnetization transfer imaging was also performed in the brain stem in all patients, and other areas of the brain were sampled in one patient. The splenium of the corpus callosum and brain stem were studied because these are often affected by diffuse axonal injury. Scans were obtained 2 to 1129 days after injury (median, 41 days). MTR was considered abnormal if it was more than 2 SD below normal. Proton MR spectroscopy was used to calculate the N-acetylaspartate (NAA)/creatine (Cr) ratio. GOS was determined at least 3 months after injury. RESULTS: In 1O patients with a GOS of 1 to 4, the mean NAA/Cr was 1.24 ± 0.28; two of these patients had abnormal MTR in normal-appearing white matter (NAWM). In 20 patients with a GOS of 5, the mean NAA/Cr was 1.53 ± 0.37 (P < .05); four of these patients had abnormal MTR in NAWM. MTR abnormalities in NAWM were identified in six patients, but these changes did not correlate with GOS or MR spectroscopy changes. CONCLUSION: MTR and MR spectroscopy can quantify damage after TBI, and NAA levels may be a sensitive indicator of the neuronal damage that results in a worse clinical outcome.

Original languageEnglish (US)
Pages (from-to)143-151
Number of pages9
JournalAmerican Journal of Neuroradiology
Volume22
Issue number1
StatePublished - 2001

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Protons
Magnetic Resonance Spectroscopy
Glasgow Coma Scale
Wounds and Injuries
Creatine
Brain Stem
Diffuse Axonal Injury
Traumatic Brain Injury
Corpus Callosum
Counseling
N-acetylaspartate
Brain
White Matter

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Sinson, G., Bagley, L. J., Cecil, K. M., Torchia, M., McGowan, J. C., Lenkinski, R. E., ... Grossman, R. I. (2001). Magnetization transfer imaging and proton MR spectroscopy in the evaluation of axonal injury: Correlation with clinical outcome after traumatic brain injury. American Journal of Neuroradiology, 22(1), 143-151.

Magnetization transfer imaging and proton MR spectroscopy in the evaluation of axonal injury : Correlation with clinical outcome after traumatic brain injury. / Sinson, G.; Bagley, L. J.; Cecil, K. M.; Torchia, M.; McGowan, J. C.; Lenkinski, R. E.; McIntosh, T. K.; Grossman, R. I.

In: American Journal of Neuroradiology, Vol. 22, No. 1, 2001, p. 143-151.

Research output: Contribution to journalArticle

Sinson, G, Bagley, LJ, Cecil, KM, Torchia, M, McGowan, JC, Lenkinski, RE, McIntosh, TK & Grossman, RI 2001, 'Magnetization transfer imaging and proton MR spectroscopy in the evaluation of axonal injury: Correlation with clinical outcome after traumatic brain injury', American Journal of Neuroradiology, vol. 22, no. 1, pp. 143-151.
Sinson, G. ; Bagley, L. J. ; Cecil, K. M. ; Torchia, M. ; McGowan, J. C. ; Lenkinski, R. E. ; McIntosh, T. K. ; Grossman, R. I. / Magnetization transfer imaging and proton MR spectroscopy in the evaluation of axonal injury : Correlation with clinical outcome after traumatic brain injury. In: American Journal of Neuroradiology. 2001 ; Vol. 22, No. 1. pp. 143-151.
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AU - Bagley, L. J.

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AU - Torchia, M.

AU - McGowan, J. C.

AU - Lenkinski, R. E.

AU - McIntosh, T. K.

AU - Grossman, R. I.

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