Diffusion Tensor Imaging Characteristics of the Corpus Callosum in Mild, Moderate, and Severe Traumatic Brain Injury

• Published in: American journal of neuroradiology : AJNR Vol. 29; no. 9; pp. 1730 - 1735
• Main Authors: Rutgers, D.R, Fillard, P, Paradot, G, Tadie, M, Lasjaunias, P, Ducreux, D
• Format: Journal Article
• Language: English
• Published: Oak Brook, IL Am Soc Neuroradiology 01.10.2008; American Society of Neuroradiology
• Subjects: Adult; Anisotropy; Bioengineering; Biological and medical sciences; Brain Concussion - diagnosis; Brain Injuries - diagnosis; Corpus Callosum - injuries; Corpus Callosum - pathology; Diffuse Axonal Injury - diagnosis; Diffuse Axonal Injury - pathology; Diffusion Magnetic Resonance Imaging; Female; Follow-Up Studies; Functional; Fundamental and applied biological sciences. Psychology; Humans; Image Processing, Computer-Assisted; Investigative techniques, diagnostic techniques (general aspects); Life Sciences; Male; Medical sciences; Middle Aged; Nerve Fibers - pathology; Nervous system; Nuclear medicine; Personality. Affectivity; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Sexuality. Sexual behavior; Young Adult; Nervous system diseases; Diffusion tensor; Radiodiagnosis; Central nervous system; Diffusion imaging; Trauma; Corpus callosum; Encephalon
• ISSN: 0195-6108; 1936-959X; 1936-959X
• DOI: 10.3174/ajnr.A1213

The corpus callosum is an important predilection site for traumatic axonal injury but may be unevenly affected in head trauma. We hypothesized that there were local differences in axonal injury within the corpus callosum as investigated with diffusion tensor imaging (DTI), varying among patients with differing severity of traumatic brain injury (TBI). Ethics committee approval and informed consent were obtained. Ten control subjects (7 men, 3 women; mean age, 37 +/- 9 years) and 39 patients with TBI (27 men, 12 women; 34 +/- 12 years) were investigated, of whom 24 had mild; 9, moderate; and 6, severe TBI. Regions of interest were selected in the callosal genu, body, and splenium to calculate fractional anisotropy (FA), apparent diffusion coefficient (ADC), and the number of fibers passing through. Statistical comparison was made through analysis of variance with the Scheffé post hoc analysis. Compared with controls, patients with mild TBI investigated <3 months posttrauma (n = 12) had reduced FA (P < .01) and increased ADC (P < .05) in the genu, whereas patients with mild TBI investigated > or =3 months posttrauma (n = 12) showed no significant differences. Patients with moderate and severe TBI, all investigated <3 months posttrauma, had reduced FA (P < .001) and increased ADC (P < .01) in the genu compared with controls and reduced FA in the splenium (P < .001) without significant ADC change. Mild TBI is associated with DTI abnormalities in the genu <3 months posttrauma. In more severe TBI, both the genu and splenium are affected. DTI suggests a larger contribution of vasogenic edema in the genu than in the splenium in TBI.