Dataset Information

T₁ and T₂ quantification using magnetic resonance fingerprinting in mild traumatic brain injury.

ABSTRACT:

Objectives

To assess whether MR fingerprinting (MRF)-based relaxation properties exhibit cross-sectional and prospective correlations with patient outcome and compare the results with those from DTI.

Methods

Clinical imaging, MRF, and DTI were acquired in patients (24 ± 10 days after injury (timepoint 1) and 90 ± 17 days after injury (timepoint 2)) and once in controls. Patient outcome was assessed with global functioning, symptom profile, and neuropsychological testing. ADC and fractional anisotropy (FA) from DTI and T₁ and T₂ from MRF were compared in 12 gray and white matter regions with Mann-Whitney tests. Bivariate associations between MR measures and outcome were assessed using the Spearman correlation and logistic regression.

Results

Data from 22 patients (38 ± 12 years; 17 women) and 18 controls (32 ± 8 years; 12 women) were analyzed. Fourteen patients (37 ± 12 years; 11 women) returned for timepoint 2, while two patients provided only timepoint 2 clinical outcome data. At timepoint 1, there were no differences between patients and controls in T₁, T₂, and ADC, while FA was lower in mTBI frontal white matter. T₁ at timepoint 1 and the change in T₁ exhibited more (n = 18) moderate to strong correlations (|r|= 0.6-0.85) with clinical outcome at timepoint 2 than T₂ (n = 3), FA (n = 7), and ADC (n = 2). High T₁ at timepoint 1, and serially increasing T₁, accounted for five of the six MR measures with the highest utility for identification of non-recovered patients at timepoint 2 (AUC > 0.80).

Conclusion

T₁ derived from MRF was found to have higher utility than T₂, FA, and ADC for predicting 3-month outcome after mTBI.

Key points

• In a region-of-interest approach, FA, ADC, and T₁ and T₂ all showed limited utility in differentiating patients from controls at an average of 24 and 90 days post-mild traumatic brain injury. • T₁ at 24 days, and the serial change in T₁, revealed more and stronger predictive correlations with clinical outcome at 90 days than did T₂, ADC, or FA. • T₁ showed better prospective identification of non-recovered patients at 90 days than ADC, T₂, and FA.

SUBMITTER: Gerhalter T

PROVIDER: S-EPMC10303381 | biostudies-literature | 2022 Feb

REPOSITORIES: biostudies-literature

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Publications

T<sub>1</sub> and T<sub>2</sub> quantification using magnetic resonance fingerprinting in mild traumatic brain injury.

Gerhalter Teresa T Cloos Martijn M Chen Anna M AM Dehkharghani Seena S Peralta Rosemary R Babb James S JS Zarate Alejandro A Bushnik Tamara T Silver Jonathan M JM Im Brian S BS Wall Stephen S Baete Steven S Madelin Guillaume G Kirov Ivan I II

European radiology 20210819 2

<h4>Objectives</h4>To assess whether MR fingerprinting (MRF)-based relaxation properties exhibit cross-sectional and prospective correlations with patient outcome and compare the results with those from DTI.<h4>Methods</h4>Clinical imaging, MRF, and DTI were acquired in patients (24 ± 10 days after injury (timepoint 1) and 90 ± 17 days after injury (timepoint 2)) and once in controls. Patient outcome was assessed with global functioning, symptom profile, and neuropsychological testing. ADC and f ...[more]

PMID: 34410458

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Project description:ImportancePersistent symptoms after mild traumatic brain injury (mTBI) represent a major public health problem.ObjectiveTo identify neuroanatomical substrates of mTBI and the optimal timing for magnetic resonance imaging (MRI).Design, setting, and participantsThis prospective multicenter cohort study encompassed all eligible patients from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study (December 19, 2014, to December 17, 2017) and a local cohort (November 20, 2012, to December 19, 2013). Patients presented to the hospital within 24 hours of an mTBI (Glasgow Coma Score, 13-15), satisfied local criteria for computed tomographic scanning, and underwent MRI scanning less than 72 hours (MR1) and 2 to 3 weeks (MR2) after injury. In addition, 104 control participants were enrolled across all sites. Data were analyzed from January 1, 2019, to December 31, 2020.ExposureMild TBI.Main outcomes and measuresVolumes and diffusion parameters were extracted via automated bespoke pipelines. Symptoms were measured using the Rivermead Post Concussion Symptoms Questionnaire in the short term and the extended Glasgow Outcome Scale at 3 months.ResultsAmong the 81 patients included in the analysis (73 CENTER-TBI and 8 local), the median age was 45 (interquartile range [IQR], 24-59; range, 14-85) years, and 57 (70.4%) were male. Structural sequences were available for all scans; diffusion data, for 73 MR1 and 79 MR2 scans. After adjustment for multiple comparisons between scans, visible lesions did not differ significantly, but cerebral white matter volume decreased (MR2:MR1 ratio, 0.98; 95% CI, 0.96-0.99) and ventricular volume increased (MR2:MR1 ratio, 1.06; 95% CI, 1.02-1.10). White matter volume was within reference limits on MR1 scans (patient to control ratio, 0.99; 95% CI, 0.97-1.01) and reduced on MR2 scans (patient to control ratio, 0.97; 95% CI, 0.95-0.99). Diffusion parameters changed significantly between scans in 13 tracts, following 1 of 3 trajectories. Symptoms measured by Rivermead Post Concussion Symptoms Questionnaire scores worsened in the progressive injury phenotype (median, +5.00; IQR, +2.00 to +5.00]), improved in the minimal change phenotype (median, -4.50; IQR, -9.25 to +1.75), and were variable in the pseudonormalization phenotype (median, 0.00; IQR, -6.25 to +9.00) (P = .02). Recovery was favorable for 33 of 65 patients (51%) and was more closely associated with MR1 than MR2 (area under the curve, 0.87 [95% CI, 0.78-0.96] vs 0.75 [95% CI, 0.62-0.87]; P = .009).Conclusions and relevanceThese findings suggest that advanced MRI reveals potential neuroanatomical substrates of mTBI in white matter and is most strongly associated with odds of recovery if performed within 72 hours, although future validation is required.

Project description:IntroductionMild traumatic brain injury (mTBI) is a common injury that can lead to temporary and, in some cases, life-long disability. Magnetic resonance imaging (MRI) is widely used to diagnose and study brain injuries and diseases, yet mTBI remains notoriously difficult to detect in structural MRI. mTBI is thought to be caused by microstructural or physiological changes in the function of the brain that cannot be adequately captured in structural imaging of the gray and white matter. However, structural MRIs may be useful in detecting significant changes in the cerebral vascular system (e.g., the blood-brain barrier (BBB), major blood vessels, and sinuses) and the ventricular system, and these changes may even be detectable in images taken by low magnetic field strength MRI scanners (<1.5T).MethodsIn this study, we induced a model of mTBI in the anesthetized rat animal model using a commonly used linear acceleration drop-weight technique. Using a 1T MRI scanner, the brain of the rat was imaged, without and with contrast, before and after mTBI on post-injury days 1, 2, 7, and 14 (i.e., P1, P2, P7, and P14).ResultsVoxel-based analyses of MRIs showed time-dependent, statistically significant T2-weighted signal hypointensities in the superior sagittal sinus (SSS) and hyperintensities of the gadolinium-enhanced T1-weighted signal in the superior subarachnoid space (SA) and blood vessels near the dorsal third ventricle. These results showed a widening, or vasodilation, of the SSS on P1 and of the SA on P1-2 on the dorsal surface of the cortex near the site of the drop-weight impact. The results also showed vasodilation of vasculature near the dorsal third ventricle and basal forebrain on P1-7.DiscussionVasodilation of the SSS and SA near the site of impact could be explained by the direct mechanical injury resulting in local changes in tissue function, oxygenation, inflammation, and blood flow dynamics. Our results agreed with literature and show that the 1T MRI scanner performs at a level comparable to higher field strength scanners for this type of research.

Dataset Information

T₁ and T₂ quantification using magnetic resonance fingerprinting in mild traumatic brain injury.

Objectives

Methods

Results

Conclusion

Key points

Publications

T<sub>1</sub> and T<sub>2</sub> quantification using magnetic resonance fingerprinting in mild traumatic brain injury.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Dataset Information

T1 and T2 quantification using magnetic resonance fingerprinting in mild traumatic brain injury.

Objectives

Methods

Results

Conclusion

Key points

Publications

T<sub>1</sub> and T<sub>2</sub> quantification using magnetic resonance fingerprinting in mild traumatic brain injury.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

T₁ and T₂ quantification using magnetic resonance fingerprinting in mild traumatic brain injury.