Table 1 Conventional magnetic resonance in traumatic brain injury
From: Clinical review: Prognostic value of magnetic resonance imaging in acute brain injury and coma
| Â | Authors (ref.) | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Â | Kampfl, 1998 [19] | Firsching, 1998 [18] | Pierallini, 2000 [30] | Yanagawa, 2000 [28] | Paterakis, 2000 [27] | Firsching, 2001 [29] | Firsching, 2002 [95] | Wedekind, 2002 [31] | Carpentier, 2006 [17] |
Study design | Case-control | Prospective | Prospective | Prospective | Prospective | Prospective | Prospective | Retrospective | Prospective |
Sequences | T1, T2 | T1, T2 | T1, T2, FLAIR | T2, T2* | T1, T2 | T1, T2 | T1, T2 | T1, T2, T2* | MRS, T2, T2* |
Inclusion criteria | VS between 6 and 8 weeks | Admission in coma (duration >24 hours) | GCS score <8, coma >1 week, post-traumatic amnesia >4 weeks | Alive after 1 week | Discrepancy between CT scan and neurological status | Admission in coma (duration >24 hours) | GCS score <8 | GCS score <8 | Severe TBI |
Number of patients | 80 | 61 | 37 | 34 | 33 | 102 | 100 | 40a | 40 |
Delay to MRI | 6 to 8 weeks | <7 days | 60 to 90 days | <3 weeks | <48 hours | <8 days | <7 days | 1 to 39 days | 17.5 ± 6.4 |
Outcome Variable of Interest | GOS score (2 versus 3–5) at 2, 3, 6, 9 and 12 months | Mortality | Clinical assessment at 3, 6 and 12 months | GOS score at 3 months | GOS score (2–3 versus 4–5) at 6 months | Mortality and outcome at 3 months to 3 yearsb | Mortality at 6 months | GOS score, DRS >6 months (mean delay: 11.3 months) | GOS score (1–2 versus 4–5) and DRS at 18 months |
Main results | Independent factor of poor outcome on multivariate analysis. Corpus callosum: OR 213.8 (95% CI 14.2 to 3213.3). Brainstem lesions OR 6.9 (95% CI 1.1 to 42.9) | Brainstem lesions: mortality rate of 44%. Bilateral brainstem lesions: mortality rate of 100% | Volume of FLAIR corpus callosum lesions correlated with first clinical evaluation. Volume of FLAIR frontal lobe lesion correlated with clinical outcome at 1 year | Number of T2 lesions correlated with GOS score. Number of T2* lesions correlated with GOS score | DAI stages correlated with outcome. No patient with good outcome had haemorrhagic DAI | Bilateral pons lesions: mortality rate of 100%. Outcome correlated with presence/absence and unilateral/bilateral brainstem lesions | Bilateral upper pontine lesion predicts mortality | More lesions of corpus callosum, basal ganglia and (para-)hippo-campal lesions in patients with brainstem lesions | Total burden of FLAIR and T2* lesions correlated with DRS and GOS score |