The roles of diffusion tensor imaging and serum biochemical indexes in the evaluation of acute mild traumatic brain injury

Abstract

Objective \nTo investigate the mild traumatic brain injury (mTBI) using diffusion tensor imaging (DTI)in MRI and the serum neuron specific enolase (NSE) and S100B protein expression changes. \n \n \nMethods \nA total of 84 patients with mild injury and 70 age and sex matched normal volunteers as controls were prospectively admitted to Department of Neurosurgery, Tianjin First Center Hospital between October 2013 and January 2016. All participants underwent Rivermead post-concussion symptoms questionnaire (RPQ) within 7 days of laboratory examination and evaluation. Among them, all patients with mTBI and 50 normal volunteers were included in this study to undergo MRI scanning, including susceptibility weighted imaging (SWI) and diffusion tensor imaging (DTI), within 7 days to compare the imaging characteristics. The patients were divided into 2 groups depending on SWI appearances. The mTBI group 1 consisted of those with positive findings in SWI and the mTBI group 2 consisted of the other patients. The differences in RPQ scores and DTI data, including fractional anisotropy (FA) and apparent diffusion coefficient (ADC), was analyzed between those 2 groups. The expression levels of serum NSE and S100B protein in the 34 patients with mTBI and 20 normal volunteers. \n \n \nResults \nAmong the 84 patients, there were 31 patients with abnormal SWI at admission and 53 patients with normal SWI, and their median RPQ scores were 17 (1-31) and 15 (22-27) respectively. There was no significant difference between the 2 groups (P=0.116). At 6 months post discharge, 20 cases in abnormal SWI group and 33 cases in normal SWI group were followed up, and their RPQ scores were 6 (1-15) and 3 (1-11) respectively(P=0.177). DTI analysis showed that there were 32 abnormal FA areas in SWI abnormal group and 7 in SWI normal group. In addition, there were 34 ADC abnormal areas in SWI abnormal group and 7 in SWI normal group. Those differences were statistically significant (P=0.001, P 0.05). \n \n \nConclusion \nThe combined detection of serum NSE and S100B protein by cranial DTI may have important clinical value and significance in accurate diagnosis and treatment of acute mTBI. \n \n \nKey words: \nCraniocerebral trauma;\xa0Diffusion tensor imaging;\xa0Mild;\xa0Neuron specific enolase;\xa0S100B protein