Diagnostic evaluation of patients with disorders of consciousness with diffusion tensor imaging

Abstract Background With the development of emergency and intensive medical technologies, the survival rate of traumatic brain injury has greatly increased. More and more patients have been converted from severe coma to alleviated state of consciousness, which can be subsequently classified within t...

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Main Authors: Long Xu, Yi Yang, Er’an Guo, Xiaogang Tao, Te Lu, Runfa Tian, Zhu Chen, Xiaoyu Xia, Qingxia Tao, Mingmei Ge, Jianghong He, Jingsheng Li, Jizong Zhao
Format: Article
Language:English
Published: BMC 2017-05-01
Series:Chinese Neurosurgical Journal
Subjects:
Online Access:http://link.springer.com/article/10.1186/s41016-017-0079-2
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author Long Xu
Yi Yang
Er’an Guo
Xiaogang Tao
Te Lu
Runfa Tian
Zhu Chen
Xiaoyu Xia
Qingxia Tao
Mingmei Ge
Jianghong He
Jingsheng Li
Jizong Zhao
author_facet Long Xu
Yi Yang
Er’an Guo
Xiaogang Tao
Te Lu
Runfa Tian
Zhu Chen
Xiaoyu Xia
Qingxia Tao
Mingmei Ge
Jianghong He
Jingsheng Li
Jizong Zhao
author_sort Long Xu
collection DOAJ
description Abstract Background With the development of emergency and intensive medical technologies, the survival rate of traumatic brain injury has greatly increased. More and more patients have been converted from severe coma to alleviated state of consciousness, which can be subsequently classified within the framework of disorders of consciousness (DOC). We investigated the clinical application and characteristics of imaging indicators of diffusion tensor imaging (DTI) for the DOC patients. Methods DTI was performed on a total of 75 cases with a clinical diagnosis of DOC from January 2014 to December 2015 in Beijing Tiantan Hospital and PLA Army General Hospital (including 66 cases of unresponsive wakefulness state (UWS) patients and 9 cases of minimally conscious state (MCS) patients). The data for the imaging indicators, such as fractional anisotropy (FA) and mean diffusivity (MD), were separately collected from three relevant regions of interest (ROIs): brainstem, thalamus, and subcortex. The indicators of two groups with different conscious states were statistically analyzed, and correlation analyses were conducted for the mean values of FA and MD in the ROIs evaluated through clinical Coma Recovery Scale-Revised (CRS-R) scores. Results The FA value of the UWS group was evidentially lower than that of the MCS group (P < 0.05), while the MD value of the UWS group was higher than that of the MCS group (P < 0.05); the difference was statistically significant. The FA and MD values in the ROIs (locations: brainstem, thalamus, and subcortex) correlated with CRS-R scores, particularly in the thalamus. Conclusion DTI has a certain clinical reference value for DOC imaging grading. The more severe the DOC, the higher the MD value and the lower the FA value.
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spelling doaj.art-52353fff44a14a1bb3a21b2a5417ae042022-12-21T23:17:12ZengBMCChinese Neurosurgical Journal2057-49672017-05-01311710.1186/s41016-017-0079-2Diagnostic evaluation of patients with disorders of consciousness with diffusion tensor imagingLong Xu0Yi Yang1Er’an Guo2Xiaogang Tao3Te Lu4Runfa Tian5Zhu Chen6Xiaoyu Xia7Qingxia Tao8Mingmei Ge9Jianghong He10Jingsheng Li11Jizong Zhao12Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurosurgery, PLA Army General HospitalDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurosurgery, PLA Army General HospitalDepartment of Neurosurgery, PLA Army General HospitalDepartment of Neurosurgery, PLA Army General HospitalDepartment of Neurosurgery, PLA Army General HospitalDepartment of Neurosurgery, PLA Army General HospitalDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityAbstract Background With the development of emergency and intensive medical technologies, the survival rate of traumatic brain injury has greatly increased. More and more patients have been converted from severe coma to alleviated state of consciousness, which can be subsequently classified within the framework of disorders of consciousness (DOC). We investigated the clinical application and characteristics of imaging indicators of diffusion tensor imaging (DTI) for the DOC patients. Methods DTI was performed on a total of 75 cases with a clinical diagnosis of DOC from January 2014 to December 2015 in Beijing Tiantan Hospital and PLA Army General Hospital (including 66 cases of unresponsive wakefulness state (UWS) patients and 9 cases of minimally conscious state (MCS) patients). The data for the imaging indicators, such as fractional anisotropy (FA) and mean diffusivity (MD), were separately collected from three relevant regions of interest (ROIs): brainstem, thalamus, and subcortex. The indicators of two groups with different conscious states were statistically analyzed, and correlation analyses were conducted for the mean values of FA and MD in the ROIs evaluated through clinical Coma Recovery Scale-Revised (CRS-R) scores. Results The FA value of the UWS group was evidentially lower than that of the MCS group (P < 0.05), while the MD value of the UWS group was higher than that of the MCS group (P < 0.05); the difference was statistically significant. The FA and MD values in the ROIs (locations: brainstem, thalamus, and subcortex) correlated with CRS-R scores, particularly in the thalamus. Conclusion DTI has a certain clinical reference value for DOC imaging grading. The more severe the DOC, the higher the MD value and the lower the FA value.http://link.springer.com/article/10.1186/s41016-017-0079-2Diffusion tensor imagingUnresponsive wakefulness stateMinimally conscious stateEvaluation
spellingShingle Long Xu
Yi Yang
Er’an Guo
Xiaogang Tao
Te Lu
Runfa Tian
Zhu Chen
Xiaoyu Xia
Qingxia Tao
Mingmei Ge
Jianghong He
Jingsheng Li
Jizong Zhao
Diagnostic evaluation of patients with disorders of consciousness with diffusion tensor imaging
Chinese Neurosurgical Journal
Diffusion tensor imaging
Unresponsive wakefulness state
Minimally conscious state
Evaluation
title Diagnostic evaluation of patients with disorders of consciousness with diffusion tensor imaging
title_full Diagnostic evaluation of patients with disorders of consciousness with diffusion tensor imaging
title_fullStr Diagnostic evaluation of patients with disorders of consciousness with diffusion tensor imaging
title_full_unstemmed Diagnostic evaluation of patients with disorders of consciousness with diffusion tensor imaging
title_short Diagnostic evaluation of patients with disorders of consciousness with diffusion tensor imaging
title_sort diagnostic evaluation of patients with disorders of consciousness with diffusion tensor imaging
topic Diffusion tensor imaging
Unresponsive wakefulness state
Minimally conscious state
Evaluation
url http://link.springer.com/article/10.1186/s41016-017-0079-2
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