MR Imaging findings of Diffuse Axonal Injury: Comparison of T2*-weighted Gradient Images and T1- andT2-weighted Spin-Echo Images

Park, Seo Young; Lee, Ghi Jai; Kim, Jeong Seok; Shim, Jae Chan; Kim, Ho Kyun

Abstract

PURPOSE: To compare T2*-weighted images with spin-echo T1- and turbo spin-echo (TSE) T2-weighted images inpatients with diffuse axonal injury(DAI)
MATERIALS AND METHODS
Using a 1.0T MR unit, SE T1-, TSE T2-, and andFLASH T2*-weighted images were obtained from 69 patients with a history of head trauma. In 18 MR images of 17patients with imaging findings of DAI, T2*-weighted images were retrospectively compared with SE T1-and TSET2-weighted images. The interval between trauma and MR scan varied from 5 days to 24 (mean, 11) months. Focusingon the number of lesions, and their location and signal intensity, as weel as associated findings, three imageswere simultaueously evaluated.
RESULTS
In 18 MR images of 17 patients with MR imaging findings of DAI, 21lesions were detected on T1-weighted images, 28 on TSE T2-weighted images, and 70 on T2*-weighted images; the lastof these revealed all lesions detected on the other two. Most lesions were hypointense on T1-weightedimages(17/21), hyperintense on TSE T2-weighted (21/28), and hypointense on T2*-weighted (63/70). Common locationsfor DAI were the frontal lobe(n=35) and corpus callosum (n=22). Associated brain injuries were cortical contusion(n=5), brainstem injury (n=3), deep gray matter injury (n=2), and subdural hematoma (n=1).
CONCLUSION
Inpatients with DAI. T2*-weighted images can detect more lesions and associated petechial hemorrhage than can TSET2-weighted images. This modality is thus useful for the evaluation of patients with head trauma.