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Quantitative Diffusion Tensor MRI Technology Diagnoses Head Injuries Not Seen on Standard MRI, CT Scans

By MedImaging International staff writers
Posted on 21 Jan 2015
An imaging center in the US state of Louisiana is now using quantitative diffusion tensor imaging (DTI), a new magnetic resonance imaging (MRI) technology, to detect brain damage that cannot be seen on standard MRI or computed tomography (CT) scans.

Doctors Imaging (Metairie, LA, USA) is one of only a few in the United States, offering quantitative DTI to better diagnose and ultimately treat concussions suffered in accidents, on the job or while playing sports. “The need to diagnose concussions quickly and accurately has become a major issue in the medical community, especially with the prevalence of head injuries among athletes,” said Dr. Edward Soll, Doctors Imaging concussion program director. “With the new quantitative DTI scans at Doctors Imaging, we can see evidence of brain injury that we weren’t able to see before and now can conclusively diagnose brain injury and better treat patients and their symptoms.”

Image: The blue spots in the DTI brain scan on the right are nerve damage not seen in the two other standard (fluid attenuation inversion recovery [FLAIR] and susceptibility-weighted imaging [SWI]) MRI scans of the same brain (Photo courtesy of Doctors Imaging).
Image: The blue spots in the DTI brain scan on the right are nerve damage not seen in the two other standard (fluid attenuation inversion recovery [FLAIR] and susceptibility-weighted imaging [SWI]) MRI scans of the same brain (Photo courtesy of Doctors Imaging).

Concussions have traditionally been difficult to diagnose. The brain can appear normal on conventional CT and MRI scans, but patients can still experience long-lasting and debilitating symptoms including dizziness, headache, depression, fatigue, nausea, and problems with behavior, concentration and memory. According to a study through the US National Institutes of Health (NIH; Bethesda, MD, USA), the quantitative DTI scans can help resolve those problems by revealing a more precise and complete image of the brain.

Dr. Soll championed quantitative DTI at Doctors Imaging in consultation with specialists at Harvard University (Cambridge, MA, USA), Johns Hopkins University (Baltimore, MD, USA), and the University of California, Los Angeles (UCLA). DTI can measure and evaluate small and slight brain injuries by comparing a patient’s scan to a control group of normal subject DTI scans. This quantitative process helps to diagnose the specifically injured areas of the brain that can help physicians confirm the presence of nerve damage. A patient undergoing a quantitative DTI scan has a similar experience to a patient having a regular brain MRI scan, but the DTI results can reveal much more.

Although the technology is new, Doctors Imaging has already effectively diagnosed patients whose traditional scans were negative. Patient 1 is a 38-year-old man who received a 12-second electric shock at work, suffering a head injury. Though MRI scans showed no damage, six months later he was still experiencing seizures and memory problems and could not perform work functions. His workers’ compensation requests were denied because the original scans showed no injury. He came to Doctor’s Imaging for a quantitative DTI scan, which revealed nerve damage corresponding with his symptoms. With this new information, he was able to begin treatment to better recover and receive the help he and his family needed.

Athletic injuries are also becoming more prevalent and serious, especially for young adults playing aggressive contact sports like football or soccer. Quantitative DTI scanning can provide a better way to evaluate the severity of injuries to begin treatment quickly or clear players to get back in the game. Doctors Imaging has already helped local student athletes, similar to patient 2, who plays football at a New Orleans (LA, USA)-area high school. He suffered a head injury during a game and his parents were worried about permanent damage. To allay fears and check his health, he underwent a quantitative DTI scan. The scan came back negative; giving his parents and coaches the confidence necessary to let him continue playing the sport.

Now that this technology is available, anyone with a recent head injury or anyone still experiencing symptoms related to a head injury, who may have had a negative MRI or CT scan is a candidate for quantitative DTI scans.

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