title: Cytotoxic and vasogenic cerebral oedema in traumatic brain injury: assessment with FLAIR and DWI imaging.
abstract: OBJECTIVE
  Cerebral oedema is a common complication of traumatic brain injury (TBI). The use of Fluid-Attenuated Inversion Recovery (FLAIR) imaging in combination with Diffusion Weighted Imaging (DWI) has the potential to distinguish between cytotoxic and vasogenic oedema. This study hypothesized a significant relationship between cytotoxic lesion volume and outcome.
  
  
  METHODS
  This observational study reports on a convenience sample where MRI was obtained for clinical purposes.
  
  
  METHODS
  Clinical post-TBI FLAIR and DWI images were analysed. For this study, lesions were defined as primarily cytotoxic oedema if the ratio of FLAIR to DWI lesion volume was comparable, defined as a ratio <2. If the ratio of FLAIR to DWI lesion volume was ≥2, oedema was considered predominantly of vasogenic origin.
  
  
  RESULTS
  The sample consisted primarily of males with TBIs whose injury severity ranged from complicated mild to severe. Analysis revealed that both oedema types are common after TBI and both are associated with functional deficits 6 months after injury.
  
  
  CONCLUSIONS
  Acute MRI may be useful to assess pathology at the tissue after traumatic brain injury. Clinical trials targeting cytotoxic and vasogenic mechanisms of oedema formation may benefit from using DWI and FLAIR MRI as a means to differentiate the predominant oedema type after TBI.
authors: Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University , Richmond, VA , USA .
authors: Anne M
authors: AM
authors: Hudak
authors: Lifang
authors: L
authors: Peng
authors: Carlos
authors: C
authors: Marquez de la Plata
authors: John
authors: J
authors: Thottakara
authors: Carol
authors: C
authors: Moore
authors: Caryn
authors: C
authors: Harper
authors: Roderick
authors: R
authors: McColl
authors: Evelyn
authors: E
authors: Babcock
authors: Ramon
authors: R
authors: Diaz-Arrastia
mesh_terms: D000328:Adult; D001929:Brain Edema / Q000175:diagnosis* / Q000473:pathology; D001930:Brain Injuries / Q000150:complications* / Q000473:pathology; D002540:Cerebral Cortex / Q000098:blood supply*; D038524:Diffusion Magnetic Resonance Imaging; D017352:Echo-Planar Imaging; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D059906:Neuroimaging / Q000295:instrumentation; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
keywords: MRI scan; Traumatic brain injury; outcome