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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.

Purpose

To compare the sensitivity of ICB identification between SWI and T2*WI and examine the prognostic value of SWI for MTBI patients.

Material and 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.

Conclusion

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.

Keywords

Susceptibility-weighted imaging (SWI)T2*-weighted imaging (T2*WI)mild traumatic brain injury post-concussive syndrome

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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