Susceptibility-weighted and diffusion kurtosis imaging to evaluate encephalomalacia with epilepsy after traumatic brain injury

Objective: Encephalomalacia after traumatic brain injury (TBI) is one of the factors leading to epilepsy. In this study, magnetic resonance imaging (MRI) was used to explore the brain image features of epilepsy after traumatic encephalomalacia, and to provide objective evidence for predicting the possible occurrence of epilepsy after traumatic encephalomalacia. Methods: Two-hundred-fifty-two patients with traumatic encephalomalacia were prospectively enrolled in the study. All patients underwent MRI after discharge from the hospital. At the 1-year follow-up, participants were divided into epilepsy and nonepilepsy groups. All participants underwent MRI including conventional imaging, susceptibility-weighted imaging (SWI), and diffusion kurtosis imaging (DKI). The lesion volume, iron deposition, mean diffusion (MD), and mean kurtosis (MK) around the lesions were calculated for each group and compared using t-tests. P values < 0.05 were considered statistically significant. Results: Sixty patients with epilepsy and 91 without epilepsy were reported. There were no significant differences in Glasgow Coma Scale (GCS), lesion volume, encephalomalacia, or MD values between the two groups. Iron deposition was significantly higher in the epilepsy group (P < 0.05). The MK values were significantly different (P < 0.05). Interpretation: Advanced MRI is an important means of evaluating risk of developing epilepsy at 1 year due to encephalomalacia in patients with TBI. SWI and DKI could be used to assess the microstructural changes around the encephalomalacia, and therefore be used to evaluate risk of developing epilepsy at 1 year.