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Fast Detection of Diffuse Axonal Damage in Severe Traumatic Brain Injury: Comparison of Gradient-Recalled Echo and Turbo Proton Echo-Planar Spectroscopic Imaging MRI Sequences

Elisabetta Giugnia, Umberto Sabatinia, Gisela E. Hagberga, Rita Formisanoa and Alessandro Castriota-Scanderbega

a From the IRCCS, Fondazione S. Lucia, Rome, Italy



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  		FIG 1. Dual-echo high resolution t-PEPSI sequence (TR/TE1/TE2/NEX = 5000/50/145/1, flip angle = 90°).

A, First-echo image obtained shows good lesion-to-tissue contrast.

B, Second image in the same shot is not of satisfactory quality for lesion detection.



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  		FIG 2. Four-echo t-PEPSI images (TR/TE1/TE2/TE3/TE4/NEX = 5000/23/64/105/145/1, flip angle = 90°).

A, On the first-echo image, susceptibility effects of the lesion have not affected the image contrast to a great extent.

B, Best lesion-to-tissue contrast is obtained around 50 msec.

C and D, At longer TEs, contrast is lost.



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  		FIG 3. Location of DAI lesions in deep intra-axial structures.

A and B, GRE (A) and t-PEPSI (B) images show lesions in the corpus callosum, posterior left internal capsule, and right thalamus.

C and D, GRE (C) and t-PEPSI (B) images show a right thalamic lesion.



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  		FIG 4. Location of DAI lesions in the deep intra-axial structures.

A and B, Lesions in the periventricular white matter and corpus callosum on GRE (A) and t-PEPSI (B) images.

C and D, GRE image (C) shows slightly abnormal decrease in SI in the left mesial temporal region and in the left posterior lateral of the midbrain. Both lesions are more easily identified on the t-PEPSI image (D).





Copyright © 2008 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X