Diagnostic Value Of Diffusion Kurtosis Imaging Combined With Magnetic Sensitive Weighted Imaging In Patients With Acute Mild Traumatic Brain Injury

Objective:To explore the application value of diffusion kurtosis imaging combined with magnetic sensitivity weighted imaging in patients with mild traumatic brain injury in acute stage.Methods:Using prospective research methods,we selected 30 patients with mild traumatic brain injury(mTBI)who were admitted to the Department of Radiology of Jilin University First Hospital from August 2020 to January2021.The patients were scored by the Glasgow Coma Scale(GCS)with a score between 13 and 15.After that,all patients underwent computed tomography(CT)and magnetic resonance imaging(MRI)within 72 hours after injury.MRI examination sequences includes T1WI,T2WI,FLAIR,DKI and ESWAN.In addition,age and sex-matched healthy volunteers were selected as the control group for the same examination.The DKI sequences were processed using the GE ADW4.5 workstation Functool.The subcortical white matter area,corpus callosum(knee,body,compression)and internal capsule(forelimbs,hindlimbs)of brain lobes(frontal,parietal,occiput,and temporal lobes)of normal control subjects and patients were selected as regions of interest(ROI),and the absolute values of FA,MD,FAK,MK,KA and KR were measured.Two experienced radiologists placed ellipses with a uniform area of 20 mm~2in the region of interest of the DKI parameter map.At least three ellipses were placed in each region and their average value was taken.The statistical method of independent sample t-test was used to compare the measured data of the MTBI group and the control group,and observe the differences between the groups.In addition,20 MTBI patients were selected for ESWAN scanning in this study,and the images obtained after scanning were analyzed:to find out whether there were hemorrhagic lesions in the brain,and the number and location of bleeding lesions were recorded.Results:1.DKI data results1.1 Compared with the control group,the FA of bilateral frontal white matter,left temporal white matter,parietal white matter,bilateral anterior and hind limbs of internal cyst,and left occipital white matter in the MTBI group were all lower than the control group,and the differences were statistically significant(P<0.05);1.2 Compared with the control group,the left temporal white matter,bilateral parietal white matter,the forelimb of the left internal capsule and the hind limb of the right internal capsule of the MTBI group were all higher than the control group,and the differences were statistically significant(P<0.05);1.3 Compared with control group,the white matter of bilateral frontal,temporal,parietal and occipital lobes,corpus callosum,forelimb of left internal capsule,forelimb and hind limb of right internal capsule of patients in MTBI group were all lower than the control group,and the differences were statistically significant(P<0.05);1.4 Compared with the control group,the MK values of the anterior and posterior limbs of the left internal capsule and the posterior limbs of the right internal capsule in the MTBI group were higher than the control group,and the differences were statistically significant(P<0.05);1.5 Compared with the control group,the Ka value in the knee of the corpus callosum of the MTBI group was higher than the control group,and the difference was statistically significant(P<0.05);1.6 Compared with the control group,the KR of bilateral frontal white matter,left parietal white matter,left occipital white matter and left internal capsule forelimb in the MTBI group were all lower than the control group,and the differences were statistically significant(P<0.05).2.ESWAN data resultsThe ESWAN examination in 20 patients was able to detect small hemorrhagic lesions in some patients that were not observed on conventional MRI sequences,such as T1WI,T2WI,and FLAIR.Statistical analysis showed that DKI combined with ESWAN had a high diagnostic sensitivity in patients with acute mTBI.Conclusion:For mTBI patients,conventional CT and MRI examinations were negative,diffusion kurtosis imaging combined with magnetic sensitivity weighted imaging can early detect abnormalities in brain functional areas of patients with mild TBI and changes in microstructures that cannot be detected by conventional MRI,providing a reliable imaging basis for clinicians and improving the diagnostic rate of mTBI.It can better track the pathophysiological changes after mTBI.