title: Current Clinical Applications and Future Potential of Diffusion Tensor Imaging in Traumatic Brain Injury.
abstract: In the setting of acute central nervous system (CNS) emergencies, computed tomography (CT) and conventional magnetic resonance imaging (MRI) play an important role in the identification of life-threatening intracranial injury. However, the full extent or even presence of brain damage frequently escapes detection by conventional CT and MRI. Advanced MRI techniques such as diffusion tensor imaging (DTI) are emerging as important adjuncts in the diagnosis of microstructural white matter injury in the acute and postacute brain-injured patient. Although DTI aids in detection of brain injury pathology, which has been repeatedly associated with typical adverse clinical outcomes, the evolution of acute changes and their long-term prognostic implications are less clear and the subject of much active research. A major aim of current research is to identify imaging-based biomarkers that can identify the subset of TBI patients who are at risk for adverse outcome and can therefore most benefit from ongoing care and rehabilitation as well as future therapeutic interventions.The aim of this study is to introduce the current methods used to obtain DTI in the clinical setting, describe a set of common interpretation strategies with their associated advantages and pitfalls, as well as illustrate the clinical utility of DTI through a set of specific patient scenarios. We conclude with a discussion of future potential for the management of TBI.
authors.affiliation: *Department of Radiology of Montefiore Medical Center, Bronx, NY †Radiology Ltd., Tuscon, AZ ‡The Gruss Magnetic Resonance Research Center of Albert Einstein College of Medicine, Bronx, NY §Department of Radiology of Albert Einstein College of Medicine, Bronx, NY ||Department of Psychiatry and Behavioral Sciences of Albert Einstein College of Medicine, Bronx, NY ¶Dominick P. Purpura Department of Neuroscience of Albert Einstein College of Medicine, Bronx, NY.
authors.forename: Sara
authors.initials: S
authors.lastname: Strauss
authors.forename: Miriam
authors.initials: M
authors.lastname: Hulkower
authors.forename: Edwin
authors.initials: E
authors.lastname: Gulko
authors.forename: Richard L
authors.initials: RL
authors.lastname: Zampolin
authors.forename: David
authors.initials: D
authors.lastname: Gutman
authors.forename: Munish
authors.initials: M
authors.lastname: Chitkara
authors.forename: Malka
authors.initials: M
authors.lastname: Zughaft
authors.forename: Michael L
authors.initials: ML
authors.lastname: Lipton
mesh_terms: D001921:Brain / Q000473:pathology; D001930:Brain Injuries / Q000473:pathology*; D056324:Diffusion Tensor Imaging / Q000379:methods* / Q000639:trends*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods* / Q000639:trends*