Lesions in deep gray nuclei after severe traumatic brain injury predict neurologic outcome

被引:10
作者
Clarencon, Frederic [1 ,2 ]
Bardinet, Eric [3 ]
Martinerie, Jacques [3 ]
Pelbarg, Vincent [4 ]
Champfleur, Nicolas Menjot dDe [5 ]
Gupta, Rajiv [6 ]
Tollard, Eleonore [7 ]
Soto-Ares, Gustavo [8 ]
Ibarrola, Danielle [9 ]
Schmitt, Emmanuelle [10 ]
Tourdias, Thomas [11 ]
Degos, Vincent [2 ,12 ]
Yelnik, Jerome [13 ]
Dormont, Didier [1 ,2 ]
Puybasset, Louis [2 ,12 ]
Galanaud, Damien [1 ,2 ]
机构
[1] Hop La Pitie Salpetriere, Dept Neuroradiol, Paris, France
[2] Paris VI Univ Pierre & Marie Curie, Paris, France
[3] CNRS, UMR 7225, Inst Cerveau & Moelle Epiniere ICM, Paris, France
[4] Brain & Spine Inst ICM, IHU A ICM, Bioinformat & Biostat Plateform, Paris, France
[5] Guy de Chauliac Univ Hosp, Dept Neuroradiol, Montpellier, France
[6] Massachusetts Gen Hosp, Dept Neuroradiol, Boston, MA 02114 USA
[7] Rouen Univ Hosp, Dept Neuroradiol, Rouen, France
[8] Roger Salengro Hosp, Dept Neuroradiol, Lille, France
[9] Pierre Wertheimer Neurol & Neurosurg Hosp, CERMEP, Bron, France
[10] Nancy Univ Hosp, Dept Neuroradiol, Nancy, France
[11] Bordeaux Univ Hosp, Dept Neuroradiol, Bordeaux, France
[12] Paris VI Univ, Pitie Salpetriere Hosp, Neurosurg Intens Care Unit, Paris, France
[13] Paris VI Univ, Pitie Salpetriere Hosp, INSERM, U679, Paris, France
来源
PLOS ONE | 2017年 / 12卷 / 11期
关键词
VEGETATIVE STATE; AXONAL INJURY; PROGNOSTIC VALUE; BASAL GANGLIA; HEAD-INJURY; CORPUS-CALLOSUM; WHITE-MATTER; MRI; STEM; NEUROPATHOLOGY;
D O I
10.1371/journal.pone.0186641
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Purpose This study evaluates the correlation between injuries to deep gray matter nuclei, as quanti-tated by lesions in these nuclei on MR T2 Fast Spin Echo (T2 FSE) images, with 6-month neurological outcome after severe traumatic brain injury (TBI). Materials and methods Ninety-five patients (80 males, mean age = 36.7y) with severe TBI were prospectively enrolled. All patients underwent a MR scan within the 45 days after the trauma that included a T2 FSE acquisition. A 3D deformable atlas of the deep gray matter was registered to this sequence; deep gray matter lesions (DGML) were evaluated using a semi-quantitative classification scheme. The 6-month outcome was dichotomized into unfavorable (death, vegetative or minimally conscious state) or favorable (minimal or no neurologic deficit) outcome. Results Sixty-six percent of the patients (63/95) had both satisfactory registration of the 3D atlas on T2 FSE and available clinical follow-up. Patients without DGML had an 89% chance (P = 0.0016) of favorable outcome while those with bilateral DGML had an 80% risk of unfavorable outcome (P = 0.00008). Multivariate analysis based on DGML accurately classified patients with unfavorable neurological outcome in 90.5% of the cases. Conclusion Lesions in deep gray matter nuclei may predict long-term outcome after severe TBI with high sensitivity and specificity.
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页数:16
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