CHICAGO - Functional magnetic resonance imaging (fMRI) is allowing radiologists to see long-term, objective changes in patients who have sustained severe head injuries.
Dr. Howard Rowley of the University of Wisconsin in Madison presented his findings at the RSNA meeting on Wednesday. In his case report, structural and functional MRI exams were performed on an 18-year-old woman who had been in a car accident two years earlier and had sustained a severe head injury with an initial Glasgow coma score of 3.
Although the patient was able to return to school and part-time work, she experienced difficulties with memory, concentration and impulse control.
Routine MRI sequences at 1.5 tesla were composed of sagittal T1, spin echo axial T2, coronal FLAIR, coronal MPGR, coronal SPGR and post gadolinium T1 axial images. Spin echo echo-planar diffusion-weighted images, gradient-echo T2* EPI-based sensorimotor tasks and GRE EPI gadolinium bolus perfusion sequences were also obtained.
The routine structural images showed evidence for poor multifocal shear and contusion injury, with T2* signal dropout affecting the splenium of the corpus callosum and several other areas. The perfusion data showed focal abnormalities of perfusion kinetics in the regions that showed abnormal T2* signal. The most severe perfusion defect was seen at the site of prior right frontal contusion.
Functional MRI could offer a noninvasive, objective way to clarify the mechanisms of brain injury and track patterns of blood flow recovery for treatment, Rowley said.
"The results are very preliminary but (the technique) looked quite robust and reproducible from lesion to lesion," he said.
By Shalmali Pal
AuntMinnie.com staff writer
December 2, 1999
