title: Improved sensitivity of 3.0 Tesla susceptibility-weighted imaging in detecting traumatic bleeds and its use in predicting outcomes in patients with mild traumatic brain injury.
abstract: BACKGROUND
  The efficacy of susceptibility-weighted imaging (SWI) for detecting intracranial bleeds (ICBs) in patients with mild traumatic brain injury (MTBI) has not been directly compared to that of T2*-weighted gradient-recalled-echo imaging (T2*WI). Further, its prognostic value for MTBI patients remains unproven.
  
  
  OBJECTIVE
  To compare the sensitivity of ICB identification between SWI and T2*WI and examine the prognostic value of SWI for MTBI patients.
  
  
  METHODS
  T2*WI, SWI, and clinical information of 63 MTBI patients were collected. Sensitivity was compared between T2*WI and SWI for ICB identification, and statistical analysis was conducted to understand the correlations between SWI and clinical characteristics.
  
  
  RESULTS
  ICBs were detected in more patients (47 vs. 35, P < 0.001) and more ICBs were detected (276 vs. 147, P < 0.001) on SWI than T2*WI. On SWI, patients with conscious disturbance showed higher ICBs prevalence (84.6% vs. 58.3%, P = 0.020), and more patients from the post-concussive syndrome (PCS)(+) group than the PCS(-)group were ICBs positive (86.1% vs. 59.3%, P = 0.015). The numbers of ICBs were significantly higher in the PCS(+) group than the PCS(-) group (P < 0.001). Significant correlation was found between PCS and ICBs number (r = 0.510, P < 0.001). Multiple logistic regression analysis showed that ICB number was an independent variable predicting occurrence of PCS.
  
  
  CONCLUSIONS
  SWI is more sensitive than T2*WI in detecting hemorrhagic foci in MTBI patients and may offer valuable prognostic information regarding these patients, for example, information on PCS. Further, cerebral parenchymal hemorrhage may affect long-term outcomes in MTBI patients.
authors.affiliation: Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, PR China.
authors.forename: Guobing
authors.initials: G
authors.lastname: Liu
authors.affiliation: Department of Radiology, Nepalgunj Medical College and Teaching Hospital, Nepal.
authors.forename: Prasanna
authors.initials: P
authors.lastname: Ghimire
authors.affiliation: Department of Radiology, Huashan Hospital, Fudan University, Shanghai, PR China.
authors.forename: Haopeng
authors.initials: H
authors.lastname: Pang
authors.affiliation: Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, PR China.
authors.forename: Guangyao
authors.initials: G
authors.lastname: Wu
authors.affiliation: Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, PR China shihongcheng1234@163.com.
authors.forename: Hongcheng
authors.initials: H
authors.lastname: Shi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000150:complications*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D020300:Intracranial Hemorrhages / Q000175:diagnosis* / Q000209:etiology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012680:Sensitivity and Specificity
keywords: Susceptibility-weighted imaging (SWI); T2*-weighted imaging (T2*WI); mild traumatic brain injury; post-concussive syndrome