Quantitative DTI: An Advanced MRI Procedure for Evaluation of Concussions
Quantitative DTI, or Diffusion Tensor Imaging, is an objective and particularly effective method for detecting nerve damage in the brain caused by concussions (mild Traumatic Brain Injury or mTBI).
How does Quantitative DTI Work?
Quantitative DTI measures water molecules as they move along the brain’s nerve pathways. In the brain, nerve cells are called “axons” and water moves in a specific direction along these pathways. Diffusion Tensor Imaging is a method in which we can measure how water moves along the nerves or what is called FA or fractional anisotropy. If a disruption in the water pathway is detected, we know that there is damage in that specific area of the brain.
The best way that Quantitative DTI testing can be performed is to use a powerful 3.0T MRI system with specific advanced neurological software and data processing capabilities. Most facilities in the greater Gulf South region offer only 1.5T MRIs. By using this powerful 3.0T MRI machine, with the necessary software and professional expertise, radiologists segment brain DTI scans into 48 regions to examine the white matter of the brain looking for nerve damage.
How Can Quantitative DTI Help Diagnose a Concussion?
The skull usually does a good job of protecting your brain. When you experience a TBI (traumatic brain injury) the FA in the brain’s white matter may be low. Low FA is an abnormality and indicates an injury to the nerve cells. Very high FA can also be observed when injuries are acute or subacute. These changes are associated with cognitive abnormalities.
What is a Concussion?
Concussion comes from the Latin word concutere meaning “to shake violently.” In essence an mTBI or concussion occurs when the brain experiences an injury significant enough to cause some of the following problems:
- A stunned or shocked feeling
- Loss of memory
- Amnesia surrounding the particulars of the injury
- Blurred vision
- Changes in sleeping patterns
- Nausea or vomiting
- Not feeling “right”
About 70% of concussion patients feel improved or “normal” about 2 weeks after the injury. However, some individuals continue to experience problems that can affect them with their ability to perform daily tasks at home, work or at school. In cases of mild traumatic brain injury or mTBI, routine MRI or CT Scans usually appear normal, but Quantitative DTI allows us to measure the microscopic brain injuries that previously were undetectable
Are DTI Tractography and Quantitative DTI the same?
Tractography creates beautiful images of the brain’s white matter pathways and this technology is of critical importance to neurosurgeons when they evaluate for tumor surgery. However tractography is of no value when we look for objective evidence of the microscopic nerve damage resulting from concussion. Concussion diagnosis requires the use of quantitative DTI.
Doctors Imaging DTI Program
Dr. Edward Soll, along with a team of MRI and other neuro-scientific experts, has developed the only quantitative Diffusion Tensor Imaging (qDTI) program currently operating in the Gulf South. In collaboration with MRI physicists and analytical/statistical PhDs from Harvard, UCLA the University of New Mexico and Johns Hopkins Medical Schools, Dr. Soll has embraced the MR imaging of the white matter microstructure in the brain and currently evaluates patients suspected of having mild traumatic brain injury (mTBI) with debilitating post-concussion syndromes. In July 2017, Dr. Soll affiliated with MINDSET, the consulting group of the Mind-Research Network at the University of New Mexico in Albuquerque, expanding control group analytics that allow for age and gender statistical integrity. These methods, combined with NeuroQuant, a volumetric analysis from CorTechs Labs, also allow for investigation of memory loss. Dr. Soll provides statistically valid data covering 48 individual regions of the brain offering vital information to neurologists, neuro-psychiatrists and neuro-psychologists allowing them to have objective anatomic correlations for patients suffering from random onset or post-injury memory loss, cognitive, emotional and executive dysfunction. His work has been helpful in evaluating hundreds of patients experiencing difficulties associated with vehicular and industrial accidents as well as explosions, toxic exposure and athletic injuries. Through his affiliation with the Tulane Institute of Sports Medicine, he serves as a consultant to the NFL Players Trust. The vast majority of patients he has studied have had earlier normal routine MRI and CT studies. qDTI testing is performed on a 3.0T Siemens MRI system operated at Doctors Imaging in Metairie, LA, just minutes from the New Orleans International Airport. Dr. Soll evaluates white matter injury by determining if a patient’s individual FA (fractional anisotropy) deviates from the normal control subject data collected for Doctors Imaging.
Looking for more information on Quantitative DTI?
The video at the top of this page, a short presentation by Dr. Soll our Concussion Program Director, provides an explanation of Quantitative DTI and how modern neuroscience has embraced its use in the evaluation of concussion injuries. Click the button below to see a Sample DTI Report.
Thanks to Quantitative DTI, radiologists have been able to locate microscopic areas in the brain where injury has occurred. In previous years, the unseen injuries of concussions remained a mystery to physicians; now they are clear and colorful and will provide insight for doctors to treat brain injuries.
If you have concerns regarding a concussion injury or memory loss or wish to schedule an appointment for a Quantitative DTI at Doctors Imaging, just call 504-883-8111 or fill out the Request Appointment form.