How important is susceptibility-weighted imaging in mild traumatic brain injury?

toprak, ugur; ersunan, gokhan; YAVASI, OZCAN; Eldes, Tugba; Bilir, Ozlem; BEYAZAL ÇELİKER, FATMA; TURAN, arzu

doi:10.14744/tjtes.2019.35485

How important is susceptibility-weighted imaging in mild traumatic brain injury?

Tuğba ELDEŞ, (Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi, Radyoloji Anabilim Dalı, Rize, Türkiye)

Fatma BEYAZAL ÇELİKER, (Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi, Radyoloji Anabilim Dalı, Rize, Türkiye)

Özlem BİLİR, (Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi, Acil Tıp Anabilim Dalı, Rize, Türkiye)

Gökhan ERSUNAN, (Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi, Acil Tıp Anabilim Dalı, Rize, Türkiye)

Özcan YAVAŞİ, (Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi, Acil Tıp Anabilim Dalı, Rize, Türkiye)

Arzu TURAN, (Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi, Radyoloji Anabilim Dalı, Rize, Türkiye)

Uğur TOPRAK (Eskişehir Osmangazi Üniversitesi Tıp Fakültesi, Radyoloji Anabilim Dalı, Eskişehir, Türkiye)

Ulusal Travma ve Acil Cerrahi Dergisi

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Yıl: 2020 Cilt: 26 Sayı: 4 Sayfa Aralığı: 574 - 579 Metin Dili: İngilizce DOI: 10.14744/tjtes.2019.35485 İndeks Tarihi: 21-10-2020

How important is susceptibility-weighted imaging in mild traumatic brain injury?

Öz:

BACKGROUND: Mild traumatic brain injury (mTBI) is a public health problem that is recognized as a “silent epidemic” in its latestages due to undiagnosed axonal damage rated 13 and above on the Glasgow Coma Scale (GCS). Injury-related microhemorrhagesoften cannot be detected on computed tomography (CT) scans and conventional magnetic resonance imaging (MRI). This study aimsto investigate whether susceptibility-weighted imaging is feasible in mTBI patients.METHODS: Fifty-eight patients with GCS scores of 14 and 15 and with symptoms of brief mental fogs, impairment of concentration,memory loss, headache, dizziness, or imbalance after brain injury were examined at the emergency service. A brain CT scan and MRIcontaining diffusion-weighted and susceptibility-weighted imaging (SWI) sequences were performed on the patients whose symptomsdid not seem to alleviate after the sixth hour. Thirteen patients were excluded from this study because of advanced age, diabetes, ahistory of hypertension or its chronic sequelae, or acute cerebrovascular disease; 45 patients were included in this study.RESULTS: The patients’ CT results were normal, and no diffusion restrictions were observed. The SWI revealed microhemorrhagesin seven patients (15.6%). Five of these patients had hyperintense areas in conventional sequences corresponding to the hemorrhagesspotted in the SWI. In three of the five patients, these pockets of hemorrhages were higher in number and size in comparison withconventional in the SWI sequence.CONCLUSION: Susceptibility-weighted imaging, which can be used to assess the presence and severity of microhemorrhages due todiffuse axonal injury, is recommended for determining the cause of symptoms in patients with mTBI, to continue targeted treatmentand prevent complications that may develop.

Anahtar Kelime:

Hafif travmatik beyin hasarında duyarlılık ağırlıklı görüntüleme ne kadar önemli?

Öz:

AMAÇ: Hafif travmatik beyin hasarı (mTBI), Glascow Koma Skalası (GCS) 13 ve üzerinde olan, tanı alamayan aksonal hasar nedeniyle geç dönemde ‘sessiz epidemik’ olarak adlandırılan bir halk sağlığı sorunudur. Bilgisayarlı tomografi (BT) ve konvansiyonel manyetik rezonans gorüntülemede (MRG) hasara bağlı mikrohemorajiler çoğunlukla görüntülenememektedir. Bu çalışmada, MRG sekanslarından duyarlılık ağırlıklı görüntülemenin (SWI) mTBI olgularında uygulanabilir olup olmadığının araştırılması amaçlanmıştır. GEREÇ VE YÖNTEM: Beyin hasarı sonrası GCS’si 14 ve 15 olan, kısa süreli bilinç bulanıklığı, konsantrasyon zorluğu, hafıza kaybı, baş ağrısı, baş dönmesi, dengesizlik gibi semptomları bulunan 58 hasta acil serviste değerlendirildi. Altıncı saatten sonra semptomları gerilemeyen hastalara beyin BT ve difüzyon ağırlıklı ve SWI sekanslarını içeren MRG çekildi. On üç hasta, ileri yaş, diyabet, hipertansiyon öyküsü ve kronik sekel değişiklikler, akut serebrovasküler hastalık bulgusu bulunması nedeniyle dışlandı. BULGULAR: Olguların BT bulguları normaldi, difüzyon ağırlıklı sekanslarda difüzyon kısıtlanması izlenmedi. Yedi hastada (%15.6) SWI’da mikrohemoraji odakları saptandı. Bunların beşinde SWI’daki mikrohemoraji alanları konvansiyonel sekanslarda hiperdens odaklar olarak izlendi. Bu olguların üçünde ise mikrohemoraji odakları sayı ve boyut açısından SWI sekansında T2A ve FLAIR’a göre artmıştı. TARTIŞMA: Diffüz aksonal hasara bağlı mikrohemoraji varlığını ve ciddiyetini değerlendirebilen SWI, hafif beyin hasarlı (mTBI) hastalarda semptomların nedenini açıklamak, nedene yönelik tedavisini sürdürmek ve gelişebilecek komplikasyonları önlemek için tavsiye edilir.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Eldes T, BEYAZAL ÇELİKER F, Bilir O, ersunan g, YAVASI O, TURAN a, toprak u (2020). How important is susceptibility-weighted imaging in mild traumatic brain injury?. , 574 - 579. 10.14744/tjtes.2019.35485
Chicago	Eldes Tugba,BEYAZAL ÇELİKER FATMA,Bilir Ozlem,ersunan gokhan,YAVASI OZCAN,TURAN arzu,toprak ugur How important is susceptibility-weighted imaging in mild traumatic brain injury?. (2020): 574 - 579. 10.14744/tjtes.2019.35485
MLA	Eldes Tugba,BEYAZAL ÇELİKER FATMA,Bilir Ozlem,ersunan gokhan,YAVASI OZCAN,TURAN arzu,toprak ugur How important is susceptibility-weighted imaging in mild traumatic brain injury?. , 2020, ss.574 - 579. 10.14744/tjtes.2019.35485
AMA	Eldes T,BEYAZAL ÇELİKER F,Bilir O,ersunan g,YAVASI O,TURAN a,toprak u How important is susceptibility-weighted imaging in mild traumatic brain injury?. . 2020; 574 - 579. 10.14744/tjtes.2019.35485
Vancouver	Eldes T,BEYAZAL ÇELİKER F,Bilir O,ersunan g,YAVASI O,TURAN a,toprak u How important is susceptibility-weighted imaging in mild traumatic brain injury?. . 2020; 574 - 579. 10.14744/tjtes.2019.35485
IEEE	Eldes T,BEYAZAL ÇELİKER F,Bilir O,ersunan g,YAVASI O,TURAN a,toprak u "How important is susceptibility-weighted imaging in mild traumatic brain injury?." , ss.574 - 579, 2020. 10.14744/tjtes.2019.35485
ISNAD	Eldes, Tugba vd. "How important is susceptibility-weighted imaging in mild traumatic brain injury?". (2020), 574-579. https://doi.org/10.14744/tjtes.2019.35485

APA	Eldes T, BEYAZAL ÇELİKER F, Bilir O, ersunan g, YAVASI O, TURAN a, toprak u (2020). How important is susceptibility-weighted imaging in mild traumatic brain injury?. Ulusal Travma ve Acil Cerrahi Dergisi, 26(4), 574 - 579. 10.14744/tjtes.2019.35485
Chicago	Eldes Tugba,BEYAZAL ÇELİKER FATMA,Bilir Ozlem,ersunan gokhan,YAVASI OZCAN,TURAN arzu,toprak ugur How important is susceptibility-weighted imaging in mild traumatic brain injury?. Ulusal Travma ve Acil Cerrahi Dergisi 26, no.4 (2020): 574 - 579. 10.14744/tjtes.2019.35485
MLA	Eldes Tugba,BEYAZAL ÇELİKER FATMA,Bilir Ozlem,ersunan gokhan,YAVASI OZCAN,TURAN arzu,toprak ugur How important is susceptibility-weighted imaging in mild traumatic brain injury?. Ulusal Travma ve Acil Cerrahi Dergisi, vol.26, no.4, 2020, ss.574 - 579. 10.14744/tjtes.2019.35485
AMA	Eldes T,BEYAZAL ÇELİKER F,Bilir O,ersunan g,YAVASI O,TURAN a,toprak u How important is susceptibility-weighted imaging in mild traumatic brain injury?. Ulusal Travma ve Acil Cerrahi Dergisi. 2020; 26(4): 574 - 579. 10.14744/tjtes.2019.35485
Vancouver	Eldes T,BEYAZAL ÇELİKER F,Bilir O,ersunan g,YAVASI O,TURAN a,toprak u How important is susceptibility-weighted imaging in mild traumatic brain injury?. Ulusal Travma ve Acil Cerrahi Dergisi. 2020; 26(4): 574 - 579. 10.14744/tjtes.2019.35485
IEEE	Eldes T,BEYAZAL ÇELİKER F,Bilir O,ersunan g,YAVASI O,TURAN a,toprak u "How important is susceptibility-weighted imaging in mild traumatic brain injury?." Ulusal Travma ve Acil Cerrahi Dergisi, 26, ss.574 - 579, 2020. 10.14744/tjtes.2019.35485
ISNAD	Eldes, Tugba vd. "How important is susceptibility-weighted imaging in mild traumatic brain injury?". Ulusal Travma ve Acil Cerrahi Dergisi 26/4 (2020), 574-579. https://doi.org/10.14744/tjtes.2019.35485