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AJNR - American Journal of Neuroradiology

Published ahead of print on November 26, 2007
doi: 10.3174/ajnr.A0856

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White Matter Abnormalities in Mild Traumatic Brain Injury: A Diffusion Tensor Imaging Study

D.R. Rutgers^a, F. Toulgoat^a, J. Cazejust^a, P. Fillard^b, P. Lasjaunias^a and D. Ducreux^a

^a Department of Neuroradiology, Centre Hospitalo-Universitaire de Bicêtre, Bicêtre, France
^b Institut National de Recherche en Informatique et Automatique, Sophia Antipolis Cedex, France

View larger version (100K): [in this window] [in a new window]   Fig 1. Selection of ROIs in a patient with mild TBI. The top row shows 2 of 30 sections of the z score map of fractional anisotropy, superimposed on a b = 0 DTI scan. Pixels with a z score less than –1.96 are highlighted in purple. Abnormal regions are visible in the splenium and genu of the corpus callosum (top left image) and in the right semiovale center (top right image). ROIs, including these abnormal pixels, were manually drawn, as illustrated in the lower row of corresponding images.

View larger version (66K): [in this window] [in a new window]   Fig 2. FLAIR scan, FA map, and fiber tracking in a 49-year-old patient with TBI who was imaged 16 months after the initial trauma. The FLAIR image shows no abnormalities (top left image). After analysis of the color-coded FA map (top middle image), a region with reduced FA was identified in the white matter of the left frontal lobe. This ROI, illustrated in the top right T2-weighted image, included forceps minor and fronto-temporo-occipital fibers (bottom left image, superior oblique view; the ROI is red and located centrally; the fibers are superimposed on an axial T2-weighted scan). At the level of the ROI, the respective fibers are discontinuous (arrow, bottom right image; the ROI is left out in this image).

View larger version (47K): [in this window] [in a new window]   Fig 3. FLAIR scan, FA map, and fiber tracking in a 38-year-old patient with TBI who was imaged 2 weeks after the initial trauma. The FLAIR image shows no abnormalities in the semiovale centers (top left image). After analysis of the color-coded FA map (top middle image), a region with reduced FA was identified in the right semiovale center. This ROI, illustrated in the top right T2-weighted image, included projection fibers (bottom left image, postero-latero-superior view; the ROI is red and located in the top right quarter of the image; the fibers are superimposed on a multiplanar T2-weighted scan that shows the lateral ventricles in white). At the level of the ROI, projection fibers are discontinuous (arrow, bottom right image; the ROI is left out in this image).