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Research ArticleBRAIN

Magnetization Transfer Imaging and Proton MR Spectroscopy in the Evaluation of Axonal Injury: Correlation with Clinical Outcome after Traumatic Brain Injury

Grant Sinson, Linda J. Bagley, Kim M. Cecil, Maria Torchia, Joseph C. McGowan, Robert E. Lenkinski, Tracy K. McIntosh and Robert I. Grossman
American Journal of Neuroradiology January 2001, 22 (1) 143-151;
Grant Sinson
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Linda J. Bagley
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Kim M. Cecil
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Maria Torchia
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Joseph C. McGowan
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Robert E. Lenkinski
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Tracy K. McIntosh
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Robert I. Grossman
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    fig 1.

    T2-weighted MR image (3000/90/1) at the level of the splenium. Asterisks indicate the regions of sampling for MTR acquisition; the box outlines the voxel for MR spectroscopy acquisition

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    fig 2.

    Proton MR spectrum obtained from normal splenium. The NAA/Cr ratio is 1.75. All spectra were acquired using a STEAM sequence (2000/31).

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    fig 3.

    T2-weighted MR images (3000/90/1) at the level of the splenium in two different patients.

    A, Despite the normal appearance of the white matter in the splenium (arrows), this patient had an MTR greater than 2 SD below normal values.

    B, This patient has typical high signal in the region of the splenium (arrows), considered an indicator of severe diffuse injury.

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    fig 4.

    A, Proton MR spectra obtained from the splenium of two patients with head injury. The arrow identifies the methyl resonance of NAA, which is at 2.02 parts per million. The top spectrum was recorded in a patient with an initial GCS of 14 and a GOS of 5 and an NAA/Cr of 1.52. The bottom spectrum shows a lowering in the NAA peak that results in a decreased NAA/Cr ratio of 1.16 in a patient with a GCS of 4 and GOS of 2.

    B, T2-weighted MR image (2700/85/1) from patient in top spectrum in A.

    C, T2-weighted MR image (2700/80/1) from patient in bottom spectrum in A shows postoperative changes from evacuation of a subdural hematoma and bilateral hygromas.

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    fig 5.

    Relationship between NAA/Cr ratio and GOS score. Spearman's rank-order correlation indicates a significant correlation between NAA/Cr and outcome (Y = 0.142X + 0.819, rs = 0.4378, P < .01).

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    fig 6.

    Relationship between NAA/Cr ratio and time interval from injury to imaging examination in both outcome groups. There was no significant correlation in either group.

Tables

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    Patients with abnormal MTR in NAWM

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American Journal of Neuroradiology
Vol. 22, Issue 1
1 Jan 2001
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Magnetization Transfer Imaging and Proton MR Spectroscopy in the Evaluation of Axonal Injury: Correlation with Clinical Outcome after Traumatic Brain Injury
Grant Sinson, Linda J. Bagley, Kim M. Cecil, Maria Torchia, Joseph C. McGowan, Robert E. Lenkinski, Tracy K. McIntosh, Robert I. Grossman
American Journal of Neuroradiology Jan 2001, 22 (1) 143-151;

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Magnetization Transfer Imaging and Proton MR Spectroscopy in the Evaluation of Axonal Injury: Correlation with Clinical Outcome after Traumatic Brain Injury
Grant Sinson, Linda J. Bagley, Kim M. Cecil, Maria Torchia, Joseph C. McGowan, Robert E. Lenkinski, Tracy K. McIntosh, Robert I. Grossman
American Journal of Neuroradiology Jan 2001, 22 (1) 143-151;
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  • Pediatric Sports-Related Concussion Produces Cerebral Blood Flow Alterations
  • Evaluation of Delayed Neuronal and Axonal Damage Secondary to Moderate and Severe Traumatic Brain Injury Using Quantitative MR Imaging Techniques
  • Whole-Brain N-Acetylaspartate: A Marker of the Severity of Mild Head Trauma
  • Proton MR Spectroscopy and MRI-Volumetry in Mild Traumatic Brain Injury
  • 1H-MR Spectroscopy, Magnetization Transfer, and Diffusion-Weighted Imaging in Alcoholic and Nonalcoholic Patients with Cirrhosis with Hepatic Encephalopathy.
  • Proton MR Spectroscopic Imaging Depicts Diffuse Axonal Injury in Children with Traumatic Brain Injury
  • Late Proton MR Spectroscopy in Children after Traumatic Brain Injury: Correlation with Cognitive Outcomes
  • A review of structural magnetic resonance neuroimaging
  • Diffusion Tensor Imaging as Potential Biomarker of White Matter Injury in Diffuse Axonal Injury
  • Magnetization transfer imaging in focal epilepsy
  • Brain Atrophy in Mild or Moderate Traumatic Brain Injury: A Longitudinal Quantitative Analysis
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