Perfusion deficits in patients with mild traumatic brain injury characterized by dynamic susceptibility contrast MRI

Perfusion deficits in patients with mild traumatic brain injury (TBI) from a military population were characterized by dynamic susceptibility contrast perfusion imaging. Relative cerebral blood flow (rCBF) was calculated by a model-independent deconvolution approach from the tracer concentration curves following a bolus injection of gadolinium diethylenetriaminepentaacetate (Gd-DTPA) using both manually and automatically selected arterial input functions (AIFs). Linear regression analysis of the mean values of rCBF from selected regions of interest showed a very good agreement between the two approaches, with a regression coefficient of R=0.88 and a slope of 0.88. The Bland-Altman plot also illustrated the good agreement between the two approaches, with a mean difference of 0.6±12.4mL/100g/min. Voxelwise analysis of rCBF maps from both approaches demonstrated multiple clusters of decreased perfusion (p<0.01) in the cerebellum, cuneus, cingulate and temporal gyrus in the group with mild TBI relative to the controls. MRI perfusion deficits in the cerebellum and anterior cingulate also correlated (p<0.01) with neurocognitive results, including the mean reaction time in the Automated Neuropsychological Assessment Metrics and commission error and detection T-scores in the Continuous Performance Test, as well as neurobehavioral scores in the Post-traumatic Stress Disorder Checklist-Civilian Version. In conclusion, rCBF calculated using AIFs selected from an automated approach demonstrated a good agreement with the corresponding results using manually selected AIFs. Group analysis of patients with mild TBI from a military population demonstrated scattered perfusion deficits, which showed significant correlations with measures of verbal memory, speed of reaction time and self-report of stress symptoms. Published 2013. This article is a U.S. Government work and is in the public domain in the USA. Perfusion deficits in patients with mild traumatic brain injury from a military population were characterized by dynamic susceptibility contrast (DSC) imaging. Relative cerebral blood flow (rCBF) calculated using arterial input functions (AIFs) selected from an automated approach demonstrated good agreement with the results obtained using manually selected AIFs. Preliminary group analysis demonstrated scattered perfusion deficits in the patient group, and the perfusion deficits in the cerebellum and anterior cingulate showed significant correlations with measures of verbal memory, speed of reaction time and self-report of stress symptoms.