New MRI Software Allows for Bettter Blast-Related Brain Injury Imaging

The new software "showed persistent abnormalities that were consistent with evolving injuries" in 47 subjects with traumatic brain injury 6 to 12 months post injury.

Full article at : New England Journal Medicine: Detection of Blast-Related Traumatic Brain Injury in U.S. Military Personnel

The researchers used new software to create "an advanced MRI method called diffusion tensor imaging (DTI), which can be performed quickly on most clinical scanners.14 DTI involves the measurement of water diffusion in multiple directions. In the white matter of the brain, water diffuses faster along the predominant fiber direction and more slowly in perpendicular directions (see Fig. S1 and S2 in the Supplementary Appendix, available with the full text of this article at NEJM.org)."

They examined "63 U.S. military personnel who had a clinical diagnosis of mild, uncomplicated traumatic brain injury. They were evacuated from the field to the Landstuhl Regional Medical Center in Landstuhl, Germany, where they underwent DTI scanning within 90 days after the injury. All the subjects had primary blast exposure plus another, blast-related mechanism of injury (e.g., being struck by a blunt object or injured in a fall or motor vehicle crash). Controls consisted of 21 military personnel who had blast exposure and other injuries but no clinical diagnosis of traumatic brain injury."

Results

"Abnormalities revealed on DTI were consistent with traumatic axonal injury in many of the subjects with traumatic brain injury. None had detectible intracranial injury on computed tomography. As compared with DTI scans in controls, the scans in the subjects with traumatic brain injury showed marked abnormalities in the middle cerebellar peduncles (P<0.001), in cingulum bundles (P=0.002), and in the right orbitofrontal white matter (P=0.007). In 18 of the 63 subjects with traumatic brain injury, a significantly greater number of abnormalities were found on DTI than would be expected by chance (P<0.001). Follow-up DTI scans in 47 subjects with traumatic brain injury 6 to 12 months after enrollment showed persistent abnormalities that were consistent with evolving injuries."