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AJNR - American Journal of Neuroradiology

Published ahead of print on July 10, 2008
doi: 10.3174/ajnr.A1213

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American Journal of Neuroradiology 29:1730-1735, October 2008
© 2008 American Society of Neuroradiology

FUNCTIONAL

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

D.R. Rutgers^a, P. Fillard^c, G. Paradot^b, M. Tadié^b, P. Lasjaunias^a and D. Ducreux^a

^a Department of Neuroradiology, Le Centre hospitalier universitaire (CHU) de Bicêtre, Le Kremlin Bicêtre, France
^b Department of Neurosurgery, Le Centre hospitalier universitaire (CHU) de Bicêtre, Le Kremlin Bicêtre, France
^c Institut National de la Recherche en Informatique et Automatique, Sophia Antipolis, France

Please address correspondence to Denis Ducreux, Department of Neuroradiology, CHU de Bicêtre, 78 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France; e-mail: denis.ducreux{at}bct.ap-hop-paris.fr

BACKGROUND AND PURPOSE: 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).

MATERIALS AND METHODS: 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.

RESULTS: 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 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.

CONCLUSION: 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.

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