Accuracy of T2WI, DWI, & SWI MRI Sequences in The Diagnosis of Diffuse Axonal Injury: A Cross-Sectional Study

Abstract

Objective: To determine the diagnostic performance of T2WI, DWI, and SWI in the diagnosis of DAI in patients with traumatic head injury.

Materials & Methods: The study was a cross-sectional study that involved 116 suspected DAI adults. Each of the participants received CT and MRI (T2WI, DWI, & SWI). The results were recorded on demographic data, clinical parameters, and imaging. Chi-square tests were used to determine diagnostic utility.

Results: The average age was 32.6 years with a standard deviation of 10.2, and 67.2% were males. Sixty- three percent of injuries were a result of road traffic accidents. DAI was established in 70.7 per cent of patients. SWI micro bleeds were detected in 55.2 per cent, and they showed a statistically significant relationship with DAI (p < 0.03). In 34.5% of the cases, there was DWI restriction in the corpus callosum, which was significantly related to DAI (p = 0.02). T2WI hyperintensities were common (67.2%), but they did not demonstrate any significant diagnostic association (p = 0.312). CT defects were not predictive of DAI.

Conclusion: SWI and DWI- especially corpus callosum involvement- have the best diagnostic value for the diagnosis of DAI when compared to CT and T2WI. SWI and DWI should be part of the regular imaging of moderate-to-severe TBI, as it significantly improves early diagnosis and clinical decision-making.