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• Clinical Article •
Research on acute whole-brain microstructural changes in mild traumatic brain injury based on DTI and DKI
LIU Wei  WEI Wei  YANG Dongkui  ZHENG Lei  WANG Haichen  ZONG Dunwei  YANG Cuiliu  HAO Yanxia  LÜ Guoshi 

Cite this article as: LIU W, WEI W, YANG D K, et al. Research on acute whole-brain microstructural changes in mild traumatic brain injury based on DTI and DKI[J]. Chin J Magn Reson Imaging, 2026, 17(10): 76-83. DOI:10.12015/issn.1674-8034.2026.10.009.


[Abstract] Objective To explore the whole brain microstructural changes in the acute phase of mild traumatic brain injury (mTBI) and the value of diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI) parameters for assessment.Materials and Methods This was a prospective case-control study. From April 2024 to May 2025, 31 patients with mTBI (mTBI group) and 30 healthy volunteers matched for age, sex, and years of education (control group) were recruited. Diagnosis of mTBI was based on a definite history of head trauma, a Glasgow Coma Scale (GCS) score of 13-15, and normal findings on post-injury CT and conventional MRI. All participants underwent DTI and DKI scans within 1-7 days after injury (acute phase). DTI data were preprocessed and metrics were calculated using MRtrix, whereas DKI data were fitted and metrics were calculated using diffusion kurtosis estimation (DKE) software. Whole-brain voxel-wise analysis was conducted using non-parametric permutation testing (Randomise program) in FSL 6.0 to compare intergroup differences, with age, sex, and years of education as covariates. Statistical significance was defined as FDR corrected P < 0.05. Demographic data were analyzed using SPSS 24.0. Intergroup comparisons were performed using the independent-sample t-test, Mann-Whitney U test, or chi-square test, with P < 0.05 considered statistically significant.Results No significant differences in age, sex, or years of education were observed between the two groups (P > 0.05). Compared with the control group, DTI revealed significantly decreased fractional anisotropy (FA) and mean diffusivity (MD) in the bilateral cerebellar lobule Ⅷ and right cerebellar lobule Ⅸ in the mTBI group (t-value range: -6.09 to -5.27, FDR corrected P < 0.05). Increased MD was observed in multiple supratentorial brain regions (including the left anterior thalamic radiation, genu of the corpus callosum, right hippocampus, right middle frontal gyrus, right medial orbitofrontal cortex, right parahippocampal gyrus, left precentral gyrus, splenium of the corpus callosum, right superior fronto-occipital fasciculus, right superior temporal gyrus, and right thalamus) (t-value range: 5.41 to 7.08, FDR corrected P < 0.05). Increased FA was noted in the left external capsule, left fusiform gyrus, and right middle temporal gyrus (t-value range: 5.30 to 5.99, FDR corrected P < 0.05). DKI revealed significantly decreased mean kurtosis (MK), axial kurtosis (AK), and radial kurtosis (RK) in the left cerebellar lobule Ⅷ (t-value range: -8.15 to -8.06, FDR corrected P < 0.05). Reduced MK and AK values were found in the left anterior thalamic radiation, left rectus gyrus, and left inferior fronto-occipital fasciculus (t-value range: -7.31 to -5.42, FDR corrected P < 0.05), whereas RK was increased in the brainstem (t = 5.88, FDR corrected P < 0.05). Decreased AK was observed in the left external capsule (t = -6.81, FDR corrected P < 0.05). Combined DTI and DKI analyses highlighted the most prominent microstructural alterations in cerebellar lobule Ⅷ.Conclusions mTBI induces widespread group-level microstructural alterations. The cerebellum, particularly cerebellar lobule Ⅷ, may serve as a sensitive target for detecting mTBI-related microstructural changes. Compared with DTI, DKI captures non-Gaussian water diffusion properties, providing more detailed microstructural information, and can serve as an important complementary tool to DTI, which can facilitate the objective evaluation of acute-phase mTBI.
[Keywords] mild traumatic brain injury；diffusion tensor imaging；diffusion kurtosis imaging；magnetic resonance imaging；axonal injury

LIU Wei   WEI Wei   YANG Dongkui   ZHENG Lei   WANG Haichen   ZONG Dunwei   YANG Cuiliu   HAO Yanxia   LÜ Guoshi*  

st Group Army of the PLA, Zhangjiakou 075000, China

Corresponding author: LÜ G S, E-mail: lament-378@163.com

Conflicts of interest   None.

Received  2026-05-13
Accepted  2026-08-23
DOI: 10.12015/issn.1674-8034.2026.10.009
Cite this article as: LIU W, WEI W, YANG D K, et al. Research on acute whole-brain microstructural changes in mild traumatic brain injury based on DTI and DKI[J]. Chin J Magn Reson Imaging, 2026, 17(10): 76-83. DOI:10.12015/issn.1674-8034.2026.10.009.

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