Ces radiol. 2015, 69(1):61-66 | DOI: 10.55095/CesRadiol2015/009

The current view on diagnostics of diffuse axonal injury by imaging methodsReview article

Jakub Stulík1, Monika Justýna Poláčková1, Marie Maxová2, Marek Mechl1
1 Radiologická klinika LF MU a FN, Brno
2 Radiologické oddělení, Nemocnice Nové Město na Moravě, p. o.

Aim: Diffuse axonal injury is traumatic brain injury arising as a result of shear movement during sudden acceleration or deceleration of the brain strongly against the rest of the body. We want to compare the capabilities of today's imaging modalities in diagnostics of diffuse axonal injury (DAI). Next, we tried in retrospective study to determine the sensitivity of computed tomography (CT) and magnetic resonance (MR) in the diagnostic of DAI and to evaluate the clinical status of patients diagnosed for DAI.

Method: We used 64-row helical CT (Philips Brilliance 64), we made native scans with soft-tissue and bone conversion. MR examination was performed on a Philips Achieva 1.5T machine using a head coil, natively in T2, T1 and GRE sequence in the transverse plane, FLAIR in coronal or sagittal plane and diffusion-weighted sequences (DWI) and ADC maps in the transversal plane. A total of 60 patients were examined.

Results: 60 patients with DAI were examined in time period from 2010-2014, 38 with diagnoses of DAI on CT and 22 on MR. 20 patients had a subsequent permanent impairment of consciousness or died, 36 had lasting consequences, 8 fully healed and in 6 patients we do not know how they ended.

Conclusion: Today native CT is the gold standard in the diagnosis of brain injury. In our group of DAI patients CT, unlike MR, had low relatively sensitivity of 63% (high specificity 97%). However, MR is not method of first choice due to its insufficient availability and time-consuming examination. MR is a useful approach for those patients whose findings on CT do not match the clinical condition. Patients diagnosed for DAP have generally a poor prognosis, 1/3 in our group of patients die or have permanent impairment of consciousness, and another 1/3 has long lasting consequences.

Keywords: axon, brain, injury

Accepted: February 10, 2015; Published: March 1, 2015  Show citation

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Stulík J, Poláčková MJ, Maxová M, Mechl M. The current view on diagnostics of diffuse axonal injury by imaging methods. Ces radiol. 2015;69(1):61-66. doi: 10.55095/CesRadiol2015/009.
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