Serial Evaluation of Diffusion Tensor Brain Fiber Tracking in a Patient with Severe Diffuse Axonal Injury
Shinji Naganawaa,
Chiho Satoa,
Shunichi Ishihrab,
Hisashi Kumadab,
Takeo Ishigakia,
Shunichi Miurab,
Masao Watanabec,
Katsuya Maruyamad and
Osamu Takizawad
a Department of Radiology, Nagoya University School of Medicine, Nagoya, Japan
a Department of Radiology, Toyohashi Municipal Hospital, Toyohashi, Aich, Japan
a Department of Neurosurgery, Toyohashi Municipal Hospital, Toyohashi, Aich, Japan
a Siemens-Asahi Medical Technologies, Tokyo, Japan
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FIG 1. A 27-year-old woman 4 days after a traffic accident.
A, Axial T1-weighted image shows the intraventricular hemorrhage in left lateral ventricule (bold arrow) and right subdural effusion. A small hemorrhage in the corpus callosum is seen (thin arrow).
B, Sagittal trace DW image (b = 1000) shows areas of high signal intensity in corpus callosum (thin arrow), especially in the splenium (bold arrow).
C, Axial echo planar T2*-weighted image (b = 0 image from DTI sequence) shows a small hemorrhage in the corpus callosum as a low signal intensity area (arrow).
D, Axial FLAIR image shows high signal intensity area in the corpus callosum (arrows). No significant damage is seen in other white matter area.
E and F, Diffusion tensor fiber tracking from the seed area around the corpus callosum. Fibers are overlayed on FA map. The view from right side of the patient shows some fibers extending up to upper frontal and parietal white matter (E, arrows). On the frontal view, upward fibers in the left side are not seen (F, arrow).
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FIG 2. A 27-year-old woman 24 days after a traffic accident.
A, Axial T1-weighted image show slight enlargement of the lateral ventricules and right subdural bloody effusion (thin arrow).
B, Sagittal trace DW image (b = 1000) shows that the areas of strong high signal intensity in the corpus callosum have moved anteriorly compared with the first MR image (thin arrow).
C, Axial echo planar T2*-weighted image (b = 0 image from DTI sequence) shows no significant hemorrhage in the corpus callosum as a low signal intensity area (arrow).
D, Axial FLAIR image shows high signal intensity area in the anterior part of the corpus callosum (arrows). No significant damage is seen in other white matter areas.
E and F, Diffusion tensor fiber tracking from the seed area around the corpus callosum is shown. Fibers are overlayed on FA map. The view from right side of the patient shows almost no fibers extending up to the upper frontal and parietal white matter (arrows, E). On the frontal view, upward fibers in the right side have almost disappeared (arrow, F).
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FIG 3. A 23-year-old male healthy volunteer for reference.
Diffusion tensor fiber tracking from the seed area around the corpus callosum. Fibers are overlayed on an FA map. The view from right side of the volunteer shows many fibers extending upward to frontal and parietal white matter from the corpus callosum (arrows, A). On the frontal view, upward fibers in the both side were visualized (arrows, B).
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