title: MR imaging in the detection of diffuse axonal injury with mild traumatic brain injury.
abstract: OBJECTIVE
  To evaluate the occurrence and distribution of mild traumatic brain injury (MTBI) caused by diffuse axonal injury (DAI) using magnetic resonance (MR) imaging and to attempt to correlate MR findings with post-concussion symptoms (PCS).
  
  
  METHODS
  Forty MTBI patients (mean age: 32.5 years) with normal cranial computed tomography (CT) findings were examined with standard MR protocol including T(1)-weighted, T(2)-weighted, fluid attenuated inversion recovery (FLAIR), gradient echo (GRE) and diffusion-weighted (DW) sequences. MR imaging was performed within 24 hours of injury. The lesions were classified as DAI based on their location and morphologic appearance.
  
  
  RESULTS
  In MR imaging of five (12.5%) of the patients, the lesions compatible with DAI were observed. Four patients (10%) had the foci of low signal intensity compatible with hemorrhagic shear injury on the GRE sequence, and five (12.5%) patients had high signal intensity on FLAIR and DW sequence.
  
  
  CONCLUSIONS
  MR imaging can be helpful in revealing DAI lesions in patients with normal CT scan findings after MTBI. FLAIR, GRE and DW sequences are superior to conventional spin-echo images in detecting DAI lesions.
authors.affiliation: Department of Radiology, Uludag University Medical School, 16059 Gorukle, Bursa, Turkey. nailebolca@yahoo.com
authors.forename: Naile Bolca
authors.initials: NB
authors.lastname: Topal
authors.forename: Bahattin
authors.initials: B
authors.lastname: Hakyemez
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Erdogan
authors.forename: Mehtap
authors.initials: M
authors.lastname: Bulut
authors.forename: Ozlem
authors.initials: O
authors.lastname: Koksal
authors.forename: Sule
authors.initials: S
authors.lastname: Akkose
authors.forename: Seref
authors.initials: S
authors.lastname: Dogan
authors.forename: Mufit
authors.initials: M
authors.lastname: Parlak
authors.forename: Halil
authors.initials: H
authors.lastname: Ozguc
authors.forename: Ender
authors.initials: E
authors.lastname: Korfali
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology*; D001930:Brain Injuries / Q000175:diagnosis / Q000473:pathology*; D020833:Diffuse Axonal Injury / Q000175:diagnosis / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D017352:Echo-Planar Imaging / Q000379:methods; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D055815:Young Adult