Haiying Tang1, Tian Liu2, Wei Liu3, Hai Pan3, Reed Selwyn1, Terry Oakes4, Yi Wang2, Gerard Riedy4
1Radiology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States; 2Biomedical Engineering, Cornell University, New York, NY, United States; 3Center for Neuroscience and Regenerative Medicine, Henry M Jackson Foundation, Bethesda, MD, United States; 4National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, United States
In the military, the Iraq and Afghanistan wars have potentially exposed more than 300,000 soldiers to mild traumatic brain injury (TBI), with more than 45,000 soldiers diagnosed with TBIs. The true incidence of TBI in the military is unknown since many cases, especially mild TBI, will have negative findings using typical clinical imaging protocols. Diagnosis of TBI with high sensitivity and specificity is a top priority for military medicine. Diffuse axonal injury (DAI), marked by petechial hemorrhage, is a trademark brain injury following blast-induced and acceleration brain movements and is not observable using conventional MRI or CT. Yet, susceptibility weighted imaging (SWI) and quantitative susceptibility mapping (QSM) can detect and quantify petechial hemorrhages, iron deposition, and calcifications that may predict DAI. We hypothesize that QSM will provide new information that is not obtained using other quantitative imaging, such as diffusion tensor imaging (DTI), which is quickly becoming the de facto standard for TBI imaging.