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Prevalence of Potentially Clinically Significant Magnetic Resonance Imaging Findings in Athletes with and without Sport-Related Concussion. J Neurotrauma 2019 06;36(11):1776-1785

Date

01/09/2019

Pubmed ID

30618331

Pubmed Central ID

PMC6551984

DOI

10.1089/neu.2018.6055

Scopus ID

2-s2.0-85066742597   15 Citations

Abstract

Previous studies have shown that mild traumatic brain injury (mTBI) can cause abnormalities in clinically relevant magnetic resonance imaging (MRI) sequences. No large-scale study, however, has prospectively assessed this in athletes with sport-related concussion (SRC). The aim of the current study was to characterize and compare the prevalence of acute, trauma-related MRI findings and clinically significant, non-specific MRI findings in athletes with and without SRC. College and high-school athletes were prospectively enrolled and participated in scanning sessions between January 2015 through August 2017. Concussed contact sport athletes (n = 138; 14 female [F]; 19.5 ± 1.6 years) completed up to four scanning sessions after SRC. Non-concussed contact (n = 135; 15 F; 19.7 ± 1.6) and non-contact athletes (n = 96; 15 F; 20.0 ± 1.7) completed similar scanning sessions and served as controls. Board-certified neuroradiologists, blinded to SRC status, reviewed T1-weighted and T2-weighted fluid-attenuated inversion recovery and T2*-weighted and T2-weighted images for acute (i.e., injury-related) or non-acute findings that prompted recommendation for clinical follow-up. Concussed athletes were more likely to have MRI findings relative to contact (30.4% vs. 15.6%; odds ratio [OR] = 2.32; p = 0.01) and non-contact control athletes (19.8%; OR = 2.11; p = 0.04). Female athletes were more likely to have MRI findings than males (43.2% vs. 19.4%; OR = 2.62; p = 0.01). One athlete with SRC had an acute, injury-related finding; group differences were largely driven by increased rate of non-specific white matter hyperintensities in concussed athletes. This prospective, large-scale study demonstrates that <1% of SRCs are associated with acute injury findings on qualitative structural MRI, providing empirical support for clinical guidelines that do not recommend use of MRI after SRC.

Author List

Klein AP, Tetzlaff JE, Bonis JM, Nelson LD, Mayer AR, Huber DL, Harezlak J, Mathews VP, Ulmer JL, Sinson GP, Nencka AS, Koch KM, Wu YC, Saykin AJ, DiFiori JP, Giza CC, Goldman J, Guskiewicz KM, Mihalik JP, Duma SM, Rowson S, Brooks A, Broglio SP, McAllister T, McCrea MA, Meier TB

Authors

Kevin M. Koch PhD Center Director, Professor in the Radiology department at Medical College of Wisconsin
Vincent Mathews MD Interim CEO MCP, President CP, Chair, Professor in the Radiology department at Medical College of Wisconsin
Michael McCrea PhD Professor in the Neurosurgery department at Medical College of Wisconsin
Timothy B. Meier PhD Associate Professor in the Neurosurgery department at Medical College of Wisconsin
Lindsay D. Nelson PhD Associate Professor in the Neurosurgery department at Medical College of Wisconsin
Andrew S. Nencka PhD Center Associate Director, Associate Professor in the Radiology department at Medical College of Wisconsin
Grant P. Sinson MD Associate Professor in the Neurosurgery department at Medical College of Wisconsin
Julie Tetzlaff PhD Associate Dean, Associate Professor in the Pathology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Athletes
Athletic Injuries
Brain
Brain Concussion
Female
Humans
Magnetic Resonance Imaging
Male
Prevalence
Young Adult