A study of magnetic resonance diffusion tensor imaging in the prognostic assessment of severe craniocerebral trauma.

Abstract

Background: Magnetic resonance diffusion tensor imaging (DTI) is recognized for its diagnostic capabilities in severe craniocerebral trauma but is less explored for its prognostic utility. This study assesses the prognostic value of DTI in predicting outcomes for patients with severe craniocerebral trauma.

Methods: We conducted a retrospective analysis of 125 patients who sustained severe craniocerebral injuries between March 2021 and September 2022. Patients were evaluated 90 days post-injury using the Glasgow Outcome Scale (GOS) and categorized into good (GOS 4-5, n = 74) and poor (GOS 1-3, n = 51) prognosis groups. DTI parameters were analyzed using logistic regression and Receiver Operating Characteristic (ROC) curves to identify prognostic indicators.

Results: No significant demographic differences were observed (P > 0.05); however, significant variances were noted in DTI parameters like ADC and FA, correlating with patient outcomes. Multifactorial analysis highlighted GCS ≤ 4, midline shift ≥5 mm, and ADC ≤ 2.7 × 10^-3 mm²/s as key predictors of poor prognosis.

Discussion: DTI provides valuable insights into the structural impacts of severe craniocerebral trauma, with ADC and FA serving as reliable indicators of prognosis. Identifying these parameters early can guide clinical interventions and potentially improve outcomes, underscoring the need for integrating DTI into routine prognostic assessments.