Temporal changes in extra-axial brain hematoma's signal intensity in magnetic resonance images of trauma patients: A preliminary, technical study. (January 2022)

• Record Type: Journal Article
• Authors: Foroughi, Amin Abolhasani; Rahmani, Ali; Borazjani, Roham; Nazeri, Masoume; Zeinali-Rafsanjani, Banafsheh; Khalili, Hosseinali
• Is Part Of: Journal of forensic and legal medicine. Volume 85(2022)
• Publication Date: 2022-01
• Subjects: Intracranial -- Extra-axial -- Hematoma -- Magnetic resonance -- Diffusion-weighted; CT Computed Tomography -- MRI Magnetic Resonance Imaging -- DWI Diffusion-weighted Imaging -- ADC Apparent Diffusion Coefficient -- ICH Intracranial Hemorrhage -- SDH Subdural Hematoma -- EDH Epidural Hematoma -- SAH Subarachnoid Hemorrhage -- IRB Institutional Review Board -- SUMS Shiraz University of Medical Sciences -- ATLS Advanced Trauma Life Support -- TR Repitition Time -- TE Echo Time -- DAI Diffuse Axonal Injury -- CSDH Chronic Subdural Hematoma; Medical jurisprudence -- Periodicals; Forensic sciences -- Periodicals; Forensic Medicine -- Periodicals; Médecine légale -- Périodiques; Electronic journals; 614.1
• DOI: 10.1016/j.jflm.2021.102296
• Languages: English
• ISSNs: 1752-928X

Abstract

Abstract: Introduction: Dating the exact or estimated time of trauma is an important issue facing forensic medicine. Several clinical and radiological methods were used to achieve this purpose. In the recent study, we aimed to track the changes in the signal intensity of the extra-axial brain hematoma using magnetic resonance imaging (MRI) conventional sequences as well as diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC). Materials and methods: Considering inclusion and exclusion criteria, all patients with blunt head trauma were involved. After proper management., stabilization, and resuscitation, the participants were assessed using conventional sequences of MRI and DWI twenty-four hours, forty-eight hours, and three weeks after the injury. Temporal changes of signal intensity were compared by Wilcoxon ranged test. Results: Sixteen patients sustaining blunt head trauma were included in this study. The study showed that during the time, diffusion restriction could be seen in an extraaxial hematoma. At the first 24 hours, the signal of hematoma was void in 87.5% of DWI and 100% of ADC. On the second day, they were hypo-signal in 75% of DWI and 100% 0f ADCs, and after three weeks, 100% of cases were hyper-signal in DWI and hypo-signal ADCs. Conclusion: This preliminary study has shown that the DWI can be used to detect and track the extra-axial hematoma. The signal intensity was void during the first twentyfour hours, although it became hypo-signal after 48 hours. Of note, the diffusion restriction is noted after three weeks. Highlights: Diffusion-Weighted Imaging (DWI) is a promising diagnostic tool to detect extra-axial hematoma at various stages. DWI is more sensitive than conventional magnetic resonance images to track the signal intensity of extra-axial hematoma. DWI and apparent diffusion coefficient could provide a more objective scale to date the extra-axial hematoma.