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

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.