• F Prieto-Valderrey, J R Muñiz-Montes, J A López-García, J Villegas-Del Ojo, J Málaga-Gil, and R Galván-García.
• Servicio de Medicina Intensiva, Hospital Santa Bárbara, Puertollano, Ciudad Real, España. fprietom@sescam.jccm.es
• Med Intensiva. 2013 Aug 1;37(6):375-82.

ObjectiveTo describe the apparent diffusion coefficient (ADC) in a series of severe traumatic brain injuries, their clinical and outcome features, and possible implications.DesignA descriptive, observational case-series study was carried out.Patients And InterventionsPatients with severe traumatic brain injuries (TBIs) admitted to the ICU were subjected to MRI study using a 1.5 T scanner. Diffusion-weighted images (DWMR) were obtained using the following echo-planar pulse sequence: TR 10000 ms, TE 126.9 ms, with b values 1000 s/mm2 in the three spatial dimensions. Combining the three sets of images, an isotropic image conforming a map of the mean ADCs was obtained.ResultsDWMR was performed in 23 patients with severe TBI admitted to the ICU between 2001 and 2004. In the MR images we selected 26 regions of interest (ROIs) where ADC was recorded. We observed a clear increase in diffusion in non-treated space-occupying lesions versus other types of injuries and the normal values. A poorer outcome was recorded in patients with lower ADC values.ConclusionsMean ADC in the lesions was greater than the normal values and greater in contusions than in other types of injuries, as an expression of extracellular edema. ADCs were decreased in patients with a poor outcome, suggesting an association between ischemia and the patient prognosis.Copyright © 2011 Elsevier España, S.L. and SEMICYUC. All rights reserved.

13 keywords...

hide…