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6 "Magnetic resonance imaging"
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Original Article
Clinical Outcomes of Diffuse Axonal Injury According to Radiological Grade
Hak-Jae Lee, Hyun-Woo Sun, Jae-Seok Lee, Nak-Joon Choi, Yoon-Joong Jung, Suk-Kyung Hong
J Trauma Inj. 2018;31(2):51-57.   Published online August 31, 2018
DOI: https://doi.org/10.20408/jti.2018.31.2.51
  • 16,766 View
  • 275 Download
  • 4 Citations
AbstractAbstract PDF
Purpose

Patients with diffuse axonal injury experience various disabilities and have a high cost of treatment. Recent researches have revealed the underlying mechanism and pathogenesis of diffuse axonal injury. This study aimed to investigate the correlation between the radiological grading of diffuse axonal injury and the clinical outcomes of patients.

Methods

From January 2011 to December 2016, among 294 patients with traumatic brain injury, 44 patients underwent magnetic resonance imaging (MRI). A total of 18 patients were enrolled in this study except for other cerebral injuries, such as cerebral hemorrhage or hypoxic brain damage. Demographic data, clinical data, and radiological findings were retrospectively reviewed. The grading of diffuse axonal injury was analyzed based on patient’s MRI findings.

Results

For the most severe diffuse axonal injury patients, prolonged intensive care unit (ICU) stay (p=0.035), hospital stay (p=0.012), and prolonged mechanical ventilation (p=0.030) were observed. However, there was no significant difference in healthcare-associated infection rates between MRI grading (p=0.123). Massive transfusion, initial hemoglobin and lactate levels, and MRI gradings were found to be highly significant in predicting the duration of unconsciousness.

Conclusions

This study showed that patients with high grade diffuse axonal injury have prolonged ICU stays and significantly longer hospital stays. Deteriorated mental patients with high energy injuries should be evaluated to identify diffuse axonal injuries by using an appropriate imaging tool, such as MRI. It will be important to predict the duration of consciousness recovery using MRI scans.

Summary

Citations

Citations to this article as recorded by  
  • Head CT for the intensivist: 10 tips and pearls
    Sajeev A. MAHENDRAN, Oliver FLOWER, J. Claude HEMPHILL III rd
    Minerva Anestesiologica.2022;[Epub]     CrossRef
  • Evaluation of Laboratory Variables Related to Diffuse Axonal Injury: A Cross-sectional Study
    Masoud Hatefi, Khalil Komlakh
    Archives of Neuroscience.2022;[Epub]     CrossRef
  • Clinical outcomes of diffuse axonal injury after traumatic brain injury according to magnetic resonance grading
    Insu Lee, Kawngwoo Park, Tae Seok Jeong, Woo-Seok Kim, Woo Kyung Kim, Do Yeon Rhee, Cheol Wan Park
    Journal of Korean Society of Geriatric Neurosurger.2021; 16(2): 71.     CrossRef
  • Use of Magnetic Resonance Imaging in Acute Traumatic Brain Injury Patients is Associated with Lower Inpatient Mortality
    Hwan Lee, Yifeng Yang, Jiehui Xu, Jeffrey B. Ware, Baogiong Liu
    Journal of Clinical Imaging Science.2021; 11: 53.     CrossRef
Case Report
A Rare Case of Lumbar Traumatic Intradiscal Hematoma Followed by Repeatative Occupation Related Minor Trauma
Woo-Keun Kwon, Jong-Keon Oh, Taek-Hyun Kwon, Youn-Kwan Park, Hong Joo Moon, Joo-Han Kim
J Trauma Inj. 2018;31(1):38-42.   Published online April 30, 2018
DOI: https://doi.org/10.20408/jti.2018.31.1.38
  • 3,416 View
  • 99 Download
AbstractAbstract PDF

A case of surgically treated intervertebral disc extrusion with intraoperatively confirmed intradiscal hematoma in a 30-year-old physical trainer is presented. Preoperative magnetic resonance imaging revealed downward migrating disc herniation, without definite suggestive findings of intradiscal hematoma. Intervertebral disc herniation with concomitant intradiscal hematoma is extremely rare, but could occur in patients who have excessive axial stress to the spine occupationally. In our case, the patient was an occupational physical trainer who had repetitive minor trauma to the lumbar spine. Although the patient did not have any clear history of major trauma to the spine, the intraoperative findings revealed intradiscal hematoma, which is very rare. The presence of intradiscal hematoma is to be suspected even when preoperative imaging studies shows indefinite findings of hematoma, considering the change in signal intensity of hematoma by time.

Summary
Original Article
The Value of X-ray Compared with Magnetic Resonance Imaging in the Diagnosis of Traumatic Vertebral Fractures
Yang Woo Lee, Jae Ho Jang, Jin Joo Kim, Yong Su Lim, Sung Youl Hyun, Hyuk Jun Yang
J Trauma Inj. 2017;30(4):158-165.   Published online December 30, 2017
DOI: https://doi.org/10.20408/jti.2017.30.4.158
  • 7,571 View
  • 111 Download
  • 2 Citations
AbstractAbstract PDF
Purpose

The purpose of this study was to evaluate the diagnostic accuracy of X-rays in patients with acute traumatic vertebral fractures visiting the emergency department and to analyze the diagnostic value of X-rays for each spine level.

Methods

We retrospectively analyzed basal characteristics by reviewing medical records of 363 patients with adult traumatic vertebral fractures, admitted to the emergency center from March 1, 2014 to February 28, 2017. We analyzed spine X-rays and magnetic resonance imaging (MRI) scans to determine distribution according to the vertebral level, and we evaluated the efficacy of X-rays by comparing discrepancies between X-rays and MRI scans.

Results

For a total of 363 patients, the mean age was 56.65 (20?93) and 214 (59%) were males. On the basis of X-rays, 67 cases (15.1%) were of the cervical spine, 133 cases (30.0%) were of the thoracic spine, and 243 cases (54.9%) were of the lumbar spine. In particular, the thoracolumbar region (T11-L2) was the most common, with 260 cases (58.7%). In X-rays, fractures were the least in the upper thoracic region (T1-T3), whereas MRI scans revealed fairly uniform distribution across the thoracic spine. Sensitivity of X-rays was lowest in the upper thoracic spine and specificity was almost always greater than 98%, except for 94.7% in L1. Positive predictive value was lower in the mid-thoracic region (T4-T9) and negative predictive value was slightly lower in C6, T2, and T3 than at other sites. Diagnostic accuracy of X-rays by vertebral body, transverse process, and spinous process according to fractured vertebral structures was significantly different according to vertebral level.

Conclusions

Diagnostic accuracy of X-rays was lower in the upper thoracic region than in other parts. Further studies are needed to identify better methods for diagnosis considering cost and neurological prognosis.

Summary

Citations

Citations to this article as recorded by  
  • A novel radiological assessment to identify acute vertebral compression fractures: A pilot observational study
    Keisuke Tsuruta, Toru Ueyama, Tomoo Watanabe, Yasunori Kobata, Kenichi Nakano, Hidetada Fukushima
    Acute Medicine & Surgery.2023;[Epub]     CrossRef
  • Forward Bending in Supine Test: Diagnostic Accuracy for Acute Vertebral Fragility Fracture
    Chan-Woo Jung, Jeongik Lee, Dae-Woong Ham, Hyun Kang, Dong-Gune Chang, Youngbae B. Kim, Young-Joon Ahn, Joo Hyun Shim, Kwang-Sup Song
    Healthcare.2022; 10(7): 1215.     CrossRef
Case Reports
A Case of Traumatic Cervical Braun-Sequard Syndrome
Dae Hyun Cho, Seung Hwan Lee, Jae Gil Lee, Myung Jae Jung
J Trauma Inj. 2017;30(3):103-106.   Published online October 30, 2017
DOI: https://doi.org/10.20408/jti.2017.30.3.103
  • 2,206 View
  • 13 Download
AbstractAbstract PDF
A traumatic Braun-Sequard syndrome of the cervical spine is reported in a 53-year-old male. The patient recovered spontaneously over several days with surgical intervention. The diagnosis was made on magnetic resonance imaging with physical examination, which also demonstrated subsequent resolution of bone marrow intensity. The etiological factors of spinal Braun-Sequard syndrome are reviewed.
Summary
Unusual Brain Computed Tomography Artifact in Cerebellum Mimicking Hemorrhage: A Case Report
Jihun Lee, Ki Seong Eom, Tae Young Kim
J Trauma Inj. 2015;28(3):195-197.   Published online September 30, 2015
DOI: https://doi.org/10.20408/jti.2015.28.3.195
  • 2,753 View
  • 29 Download
AbstractAbstract PDF
Artifacts can seriously degrade the quality of computed tomography (CT) images, sometimes to the point of making them diagnostically unusable. Here, we report an unusual CT artifact that could have resulted in the misdiagnosis of a hyperdense hemorrhagic lesion in a 55-year-old man. The author recommend that when hemorrhagic lesion in posterior fossa is suggested on CT, the physician should carefully consider all patient-related clinical data prior to considering surgical intervention or a biopsy. Cranial magnetic resonance imaging (MRI) can help in preventing the misdiagnosis as hemorrhage of CT scan.
Summary
Original Article
Prognostic Value of Computed Tomography and Gradient-echo Magnetic Resonance Imaging in Diffuse Axonal Injury
Nam Ki Jung, Sang Chan Jin, Woo Ik Choi
J Trauma Inj. 2012;25(4):122-131.
  • 1,054 View
  • 5 Download
AbstractAbstract PDF
PURPOSE
Diffuse axonal injury (DAI) is clinically defined as a coma of over six hours in a head trauma victim without a focal mass lesion. The emergency physician usually resuscitates and stabilizes a comatose head trauma victim in the emergency Department. After assessment and treatment, the prognosis is very important to both the victim and the physician. The prognosis for DAI is based on Glasgow Coma Scale (GCS) and other imaging data. We investigated the prognostic value of computed tomography (CT) and gradient-echo magnetic resonance imaging (GRI) for head trauma victims with DAI.
METHODS
Fifty-three(53) head trauma victims of DAI were enrolled in this study from 2007 to 2012. During the study period of six years, data on trauma victims were collected retrospectively. We analyzed the differences in the Glasgow Outcome Scale (GOS) result between the CT and the GRI modalities.
RESULTS
We classified the study group by using GOS. Between the good outcome subgroup (GOS scores of 4 and 5) and the poor outcome subgroup (GOS score of 1-3), there were no statistical difference in sex, age, initial vital signs and initial GCS score. The good outcome subgroup had non-hemorrhage on CT(52%), which was correlated with good outcome and a shorter awakening time, while a larger number and a deeper location of hemorrhagic lesions on in GRI were correlated with poor outcome in DAI.
CONCLUSION
We conclude that the existence of hemorrhagic lesions on CT, and the number and location of those lesions on GRI had good prognostic value for head trauma victims with DAI.
Summary

J Trauma Inj : Journal of Trauma and Injury