Neuroimaging clinics of North America
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Remarkable advances have been made in the last decade in the use of diffusion MR imaging to study mild traumatic brain injury (mTBI). Diffusion imaging shows differences between mTBI patients and healthy control groups in multiple different metrics using a variety of techniques, supporting the notion that there are microstructural injuries in mTBI patients that radiologists have been insensitive to. Future areas of discovery in diffusion MR imaging and mTBI include larger longitudinal studies to better understand the evolution of the injury and unravel the biophysical meaning that the detected changes in diffusion MR imaging represent.
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Traumatic brain injury (TBI) is a significant problem worldwide and neuroimaging plays a critical role in diagnosis and management. Recently, perfusion neuroimaging techniques have been explored in TBI to determine and characterize potential perfusion neuroimaging biomarkers to aid in diagnosis, treatment, and prognosis. In this article, computed tomography (CT) bolus perfusion, MR imaging bolus perfusion, MR imaging arterial spin labeling perfusion, and xenon CT are reviewed with a focus on their applications in acute TBI. Future research directions are also discussed.
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Neuroimaging Clin. N. Am. · Feb 2018
ReviewConventional Computed Tomography and Magnetic Resonance in Brain Concussion.
Conventional neuroimaging is still the mainstay in the assessment of the acute, follow-up, and chronic settings of concussion and mild traumatic brain injury (mTBI). Computed tomography (CT) is preferred for the initial assessment of acute mTBI, repeat evaluation in acute mTBI with neurologic deterioration, and cautious use in children with mTBI. Clinical rules have been developed to identify pediatric and adult patients with mTBI who can safely forego CT. Magnetic resonance (MR) imaging is mostly used in patients with acute mTBI when initial or follow-up CT is normal and there are persistent neurologic findings and in subacute or chronic mTBI.
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Neuroimaging Clin. N. Am. · Feb 2018
ReviewFunctional MR Imaging: Blood Oxygen Level-Dependent and Resting State Techniques in Mild Traumatic Brain Injury.
This article discusses mild traumatic brain injury (mTBI)-associated effects on brain functional connectivity assessed via resting-state functional MR (fMR) imaging. Several studies have reported acute post-injury default mode network hyperconnectivity, followed by a period of decreased connectivity before later connectivity normalization in some patients. Other studies have reported mTBI associated effects on connectivity that remain evident for up to 5-years or more. Discordance in the published literature regarding the direction of network connectivity changes (eg, increased versus decreased connectivity) may reflect differences in timing of data collection post-injury, as well as the need to standardize MR imaging acquisition protocols and processing methods.
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Neuroimaging Clin. N. Am. · Feb 2018
ReviewPET and Single-Photon Emission Computed Tomography in Brain Concussion.
This article offers an overview of the application of PET and single photon emission computed tomography brain imaging to concussion, a type of mild traumatic brain injury and traumatic brain injury, in general. The article reviews the application of these neuronuclear imaging modalities in cross-sectional and longitudinal studies. Additionally, this article frames the current literature with an overview of the basic physics and radiation exposure risks of each modality.