Diffusion Kurtosis Imaging in Assessing Brain Injury of Different Clinical Stages Caused by Carbon Monoxide Poisoning / 中国医学影像学杂志

ABSTRACT

Purpose To explore the application value of diffusion kurtosis imaging (DKI) in assessing brain injury in different clinical stages caused by carbon monoxide (CO) poisoning. Materials and Methods MR plain scan, diffusion weighted imaging (DWI) and DKI scans were performed in 26 patients with acute CO poisoning, 17 patients with delayed neuropsychologic sequelae (DNS), 15 patients with chronic phase, and 21 healthy volunteers (control group). The DKI parameter values in regions of interest among the four groups were compared, and the correlation between the values of each parameter and DWI apparent diffusion coefficient (ADC) value was analyzed. Results ①The mean kurtosis (MK) values in the area of pallidum in acute phase, DNS phase, and chronic phase were 1.51±0.15, 1.07±0.11 and 0.59±0.11, respectively; among which the MK value in acute phase was significantly higher than that in the control group (1.06±0.06, P<0.05), and the chronic phase was significantly lower than the DNS phase and the control group (P<0.05); compared with the control group, the MK in centrum semiovale and subcallosal zone was relatively higher in acute phase and DNS phase, lower in chronic phase, both showing the most significant increase in DNS phase (P<0.05). ②In each region of interest, the MK value and mean diffusivity (MD) all showed an increase after decrease. Among them, MD values in the area of pallidum in acute phase were significantly lower than those in DNS and control group (0.74±0.11 vs. 0.85±0.07 and 0.98±0.12, P<0.05), and the centrum semiovale and callosum were the smallest in DNS phase (0.67±0.09 and 0.80±0.05, respectively), significantly lower than that in the control group (P<0.05). ③The fractional anisotropy (FA) values of all regions of interest showed a progressive decrease in different clinical stages, in which pallidum and centrum semiovale were the lowest in chronic phase (0.19±0.04 and 0.22±0.03, respectively), significantly lower than those in DNS phase and the control group (P<0.05). ④There was a positive correlation between MD values and ADC values in different clinical stages of CO poisoning in each region of interest (P<0.01). Conclusion DKI can quantitatively evaluate the changes of brain gray matter microarchitecture after CO poisoning, which is helpful to understand the characteristics of brain injury in different clinical stages caused by CO poisoning from the microscopic level.