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Journal of Trauma and Injury 2012;25(4):122-131.
Prognostic Value of Computed Tomography and Gradient-echo Magnetic Resonance Imaging in Diffuse Axonal Injury
Nam Ki Jung, Sang Chan Jin, Woo Ik Choi
Department of Emergency Medicine, School of Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea. emtaegu@dsmc.or.kr
미만성 축삭 손상에서 전산화단층촬영과
경사에코 자기공명영상을 이용한 예후의 평가
정남기∙진상찬∙최우익
계명대학교 의과대학 동산의료원 응급의학과
Received: 28 August 2012   • Revised: 5 October 2012   • Accepted: 5 October 2012
Abstract
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.
Key Words: Head injury; Diffuse axonal injury; Multidetector computed tomography; Magnetic resonance imaging


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