Traumatic Cerebral Microbleeds in the Subacute Phase Are Practical and Early Predictors of Abnormality of the Normal-Appearing White Matter in the Chronic Phase
- 25 February 2021
- journal article
- research article
- Published by American Society of Neuroradiology (ASNR) in American Journal of Neuroradiology
- Vol. 42 (5), 861-867
- https://doi.org/10.3174/ajnr.a7028
Abstract
BACKGROUND AND PURPOSE: In the chronic phase after traumatic brain injury, DTI findings reflect WM integrity. DTI interpretation in the subacute phase is less straightforward. Microbleed evaluation with SWI is straightforward in both phases. We evaluated whether the microbleed concentration in the subacute phase is associated with the integrity of normal-appearing WM in the chronic phase. MATERIALS AND METHODS: Sixty of 211 consecutive patients 18 years of age or older admitted to our emergency department ≤24 hours after moderate to severe traumatic brain injury matched the selection criteria. Standardized 3T SWI, DTI, and T1WI were obtained 3 and 26 weeks after traumatic brain injury in 31 patients and 24 healthy volunteers. At baseline, microbleed concentrations were calculated. At follow-up, mean diffusivity (MD) was calculated in the normal-appearing WM in reference to the healthy volunteers (MDz). Through linear regression, we evaluated the relation between microbleed concentration and MDz in predefined structures. RESULTS: In the cerebral hemispheres, MDz at follow-up was independently associated with the microbleed concentration at baseline (left: B = 38.4 [95% CI 7.5–69.3], P = .017; right: B = 26.3 [95% CI 5.7–47.0], P = .014). No such relation was demonstrated in the central brain. MDz in the corpus callosum was independently associated with the microbleed concentration in the structures connected by WM tracts running through the corpus callosum (B = 20.0 [95% CI 24.8–75.2], P < .000). MDz in the central brain was independently associated with the microbleed concentration in the cerebral hemispheres (B = 25.7 [95% CI 3.9–47.5], P = .023). CONCLUSIONS: SWI-assessed microbleeds in the subacute phase are associated with DTI-based WM integrity in the chronic phase. These associations are found both within regions and between functionally connected regions.Funding Information
- Trauma Regio Oost, Radboudumc, Nijmegen (no numbered grant (This is an investigator-initiat)
- Stichting Fonds Catharine van Tussenbroek (B-9 travel grant for Anke W van der Eerden, to sup)
This publication has 33 references indexed in Scilit:
- The relationship between diffusion tensor imaging findings and cognitive outcomes following adult traumatic brain injury: A meta-analysisNeuroscience & Biobehavioral Reviews, 2018
- Cerebral Microbleeds: Imaging and Clinical SignificanceRadiology, 2018
- The International Incidence of Traumatic Brain Injury: A Systematic Review and Meta-AnalysisCanadian Journal of Neurological Sciences, 2016
- Epidemiology of traumatic brain injury in EuropeActa Neurochirurgica, 2015
- Longitudinal study of diffusion tensor imaging properties of affected cortical spinal tracts in acute and chronic hemorrhagic strokeJournal of Clinical Neuroscience, 2014
- A Decade of DTI in Traumatic Brain Injury: 10 Years and 100 Articles LaterAmerican Journal of Neuroradiology, 2013
- A review of magnetic resonance imaging and diffusion tensor imaging findings in mild traumatic brain injuryBrain Imaging and Behavior, 2012
- Prevalence and impact of diffuse axonal injury in patients with moderate and severe head injury: a cohort study of early magnetic resonance imaging findings and 1-year outcomeJournal of Neurosurgery, 2010
- Diffusion Tensor Imaging in Chronic Subdural Hematoma: Correlation between Clinical Signs and Fractional Anisotropy in the Pyramidal TractAmerican Journal of Neuroradiology, 2008
- Diffusion tensor imaging during recovery from severe traumatic brain injury and relation to clinical outcome: a longitudinal studyBrain, 2007