Mild traumatic brain injury: tissue texture analysis correlated to neuropsychological and DTI findings

Rationale and objectives: The aim of this study was to evaluate whether texture analysis (TA) can detect subtle changes in cerebral tissue caused by mild traumatic brain injury (MTBI) and to determine whether these changes correlate with neuropsychological and diffusion tensor imaging (DTI) findings.

Materials and methods: Forty-two patients with MTBIs were imaged using 1.5T magnetic resonance imaging within 3 weeks after head injury. TA was performed for the regions corresponding to the mesencephalon, centrum semiovale, and corpus callosum. Using DTI, the fractional anisotropic and apparent diffusion coefficient values for the same regions were evaluated. The same analyses were performed on a group of 10 healthy volunteers. Patients also underwent a battery of neurocognitive tests within 6 weeks after injury.

Results: TA revealed textural differences between the right and left hemispheres in patients with MTBIs, whereas differences were minimal in healthy controls. A significant correlation was found between scores on memory tests and texture parameters (sum of squares, sum entropy, inverse difference moment, and sum average) in patients in the area of the mesencephalon and the genu of the corpus callosum. Significant correlations were also found between texture parameters for the left mesencephalon and both fractional anisotropic and apparent diffusion coefficient values.

Conclusions: The data suggest that heterogeneous texture and abnormal DTI patterns in the area of the mesencephalon may be linked with verbal memory deficits among patients with MTBIs. Therefore, TA combined with DTI in patients with MTBIs may increase the ability to detect early and subtle neuropathologic changes.