Prediction of Motor Function Outcome in Patients with Brain Injury Using Computed Tomography and Diffusion Tensor Image

Corresponding author: Soon Ki Sung Department of Neurosurgery, Pusan National University Yangsan Hospital, 20, Geumo-ro, Mulgeum-eup, Yangsan 50612, Republic of Korea Tel: +82-55-360-2126 Fax: +82-55-360-2156 E-mail: soonkisung@pusan.ac.kr Objective: Diffusion tensor imaging (DTI) was used to study motor function prognosis in stroke and intracerebral hemorrhage (ICH) patients. In this study, we investigated the correlation between DTI and computed tomography (CT) and compared the predictability of clinical outcome in patients with stoke, ICH, brain tumor, and traumatic brain injury. Methods: We retrospectively reviewed 22 patients with brain injury who underwent DTI and CT. Motor weakness was assessed using the Medical Research Council (MRC) grade scores. The fractional anisotropy (FA) of the region of interest (ROI) of DTI was compared between the injured and non-injured sites. Results: The differences in the encephalomalacic changes of corticospinal tract injury between DTI and CT were not statistically significant in patients with motor weakness (p=0.09). Neither modality could predict the motor recovery rate (CT, p=0.89; DTI, p=0.86). However, DTI showed a significant difference in initial MRC grade (p=0.003). We evaluated the possibility of more accurate evaluation of MRC grade change using DTI. FA ROI in injured (450.73±105.32) and non-injured (582.18±99.68) sites showed a significant difference (p=0.00). Pearson’s correlation coefficient showed that FA ROI ratio had a significant correlation with initial (p=0.43) and follow-up (p=0.012) MRC grades, but not with MRC grade change (p=0.67). Conclusion: DTI is more accurate than CT for evaluating motor deficit. It aids the treatment and rehabilitation plans in patients with brain injury. However, the prediction of motor function recovery is still insufficient.