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01-03-2019 | Neuro

Quantitative dynamic contrast-enhanced MR imaging shows widespread blood-brain barrier disruption in mild traumatic brain injury patients with post-concussion syndrome

Authors: Roh-Eul Yoo, Seung Hong Choi, Byung-Mo Oh, Sang Do Shin, Eun Jung Lee, Dong Jae Shin, Sang Won Jo, Koung Mi Kang, Tae Jin Yun, Ji-hoon Kim, Chul-Ho Sohn

Published in: European Radiology | Issue 3/2019

Abstract

Objectives

To explore the utility of dynamic contrast-enhanced (DCE) MR imaging for quantitative analysis of blood-brain barrier disruption in mild traumatic brain injury (mTBI) patients with post-concussion syndrome (PCS).

Methods

Forty-four consecutive patients with PCS after mTBI and 32 controls were included in this retrospective study. K^trans and v_e from DCE MR imaging were analyzed at contrast-enhancing lesions, T2 hyperintense white matter (WM) lesions, normal-appearing white matter (NAWM), and predilection sites for diffuse axonal injury (Location_DAI). The Mann-Whitney U-test was performed to compare the parameters between mTBI patients and controls and the parameters were correlated with neuropsychological tests using Mann-Whitney U-test and Spearman rank correlation.

Results

The median v_e of the T2 hyperintense WM lesions in mTBI patients (n=21) was higher than that of NAWM in controls (p=.027). Both median K^trans and v_e at NAWM were also significantly higher in mTBI patients than in controls (p=.023 and p=.029, respectively). In addition, mTBI patients had higher K^trans and v_e at Location_DAI than controls (p=.008 and p=.015, respectively). VLT (delayed recall) scores were significantly correlated with v_e values at T2 hyperintense WM lesions (p=−0.767, p=.044). The median v_e at Location_DAI was significantly higher in patients with atypical performance in the digit span test (forward) than in those with average or good performance (p=.043).

Conclusions

mTBI patients with PCS had higher K^trans and v_e values than controls not only at T2 hyperintense WM lesions but also at NAWM and Location_DAI. BBB disruption may be implicated in development of PCS in mTBI patients.

Key Points

• mTBI patients with PCS had higher permeability than controls at T2 hyperintense WM lesions on DCE MR imaging.

• mTBI patients with PCS had higher permeability than controls also at NAWM and predilection sites for DAI.

• BBB disruption may be implicated in the development of PCS in mTBI patients.

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Title: Quantitative dynamic contrast-enhanced MR imaging shows widespread blood-brain barrier disruption in mild traumatic brain injury patients with post-concussion syndrome
Authors: Roh-Eul Yoo
Seung Hong Choi
Byung-Mo Oh
Sang Do Shin
Eun Jung Lee
Dong Jae Shin
Sang Won Jo
Koung Mi Kang
Tae Jin Yun
Ji-hoon Kim
Chul-Ho Sohn
Publication date: 01-03-2019
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 3/2019
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-018-5656-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Quantitative dynamic contrast-enhanced MR imaging shows widespread blood-brain barrier disruption in mild traumatic brain injury patients with post-concussion syndrome

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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