Investigation of detection of diffuse axonal injury in non-contrast computed tomography examinations with histogram analysis method.

Diffuse axonal injury (DAH) is a brain injury caused by acceleration-deceleration and rotational forces that cause shear stress in the axons in the white matter tracts and is a serious form of traumatic brain injury. It is potentially difficult to diagnose with a single imaging, especially as the findings on computed tomography can be subtle, however it has the potential to cause severe neurological impairment. Therefore, the aim of this study is to investigate the detectability of diffuse axonal injuries in trauma patients using histogram analysis method in computed tomography examinations. This study was planned retrospectively and using the database of Fırat University Hospital, 30 cases with DAH detected in cranial magnetic resonance imaging (MRI) but not found in the first cranial CT were evaluated. A total of 451 samples were studied, of which 283 were in the DAH sample group and 168 in the control sample group. Of the DAH sample group, 246 (86.9%) were hemorrhagic and 37 (13.1%) were non-hemorrhagic. The lesion areas defined as DAH in the axial MRI images were marked as ROI (Region of interest) in the axial CT images, and histogram analysis findings were obtained by processing with a specially written MATLAB© program. Histogram analysis findings obtained from non-contrast CT images in our study showed significant differences between the DAH sample group and the control sample group. Another histogram analysis was created by grouping the entire sample group as hemorrhagic and non-hemorrhagic. Significant differences were also obtained in histogram parameters between the two sample groups. In conclusion, in this study, which is the first histogram analysis for this patient group, DAH histogram analysis findings obtained from non-contrast brain CT images reveal the detectability of DAH without the need for additional imaging or radiation when radiological differentiation of DAH is not possible in trauma patients. It was concluded that the histogram analysis would be beneficial for the detection of diffuse axonal injury and its treatment and prognosis. Key Words: Diffüse Axonal İnjury; Histogram Analysis; Computer Tomography; Brain İnjury