Prevalence of Traumatic Findings on Routine MRI in a Large Cohort of Professional Fighters

BACKGROUND AND PURPOSE

Previous studies investigating MR imaging abnormalities among fighters have had small sample sizes. This investigation assessed a large number of fighters using the same conventional sequences on the same scanner.

MATERIALS AND METHODS

Conventional 3T MR imaging was used to assess 499 fighters (boxers, mixed martial artists, and martial artists) and 62 controls for nonspecific WM changes, cerebral microhemorrhage, cavum septum pellucidum, and cavum vergae. The lengths of the cavum septum pellucidum and cavum vergae and the ratio of cavum septum pellucidum to the septum pellucidum lengths were assessed.

RESULTS

The prevalence of nonspecific WM changes was similar between groups. Fighters had a prevalence of cerebral microhemorrhage (4.2% versus 0% for controls, P = .152). Fighters had a higher prevalence of cavum septum pellucidum versus controls (53.1% versus 17.7%, P < .001) and cavum vergae versus controls (14.4% versus 0%, P < .001). The lengths of the cavum septum pellucidum plus the cavum vergae (P < .001), cavum septum pellucidum (P = .025), and cavum septum pellucidum to the septum pellucidum length ratio (P = .009) were higher in fighters than in controls. The number of fights slightly correlated with cavum septum pellucidum plus cavum vergae length (R = 0.306, P < .001) and cavum septum pellucidum length (R = 0.278, P < .001). When fighters were subdivided into boxers, mixed martial artists, and martial artists, results were similar to those in the whole-group analysis.

CONCLUSIONS

This study assessed MR imaging findings in a large cohort demonstrating a significantly increased prevalence of cavum septum pellucidum among fighters. Although cerebral microhemorrhages were higher in fighters than in controls, this finding was not statistically significant, possibly partially due to underpowering of the study.

Quantitative analysis of the effects of physiologic brain motion on point-resolved spectroscopy

BACKGROUND AND PURPOSE

Although single-voxel proton MR spectroscopy is a noninvasive method that enables measurement of brain metabolite concentrations, it has been shown that physiologic brain motion causes inaccuracies in measurement of metabolite concentrations and increases the overall SD of the measurements when the stimulated echo acquisition mode (STEAM) is used. We tested the hypothesis that the point-resolved spectroscopy (PRESS) technique is less sensitive to physiologic brain motion than the STEAM technique.

METHODS

In 10 healthy subjects, spectra were obtained from a voxel located in the left basal ganglia by using the PRESS sequence with cardiac gating and without water suppression to assess global phase change as a function of physiologic brain motion. This was accomplished by acquiring data at various time delays from the R wave throughout the cardiac cycle. Subsequently, spectra were obtained in 10 healthy subjects by using PRESS both without and with cardiac gating, and with water suppression, to determine whether brain motion resulted in a statistically significant difference in mean and SD of measured metabolite concentration.

RESULTS

At various time delays from the R wave throughout the cardiac cycle, no significant global phase difference was noted in water signal intensity. In addition, when PRESS data were obtained both without and with cardiac gating (by using an optimal delay obtained from previously published data by using STEAM), no significant difference was seen in measured metabolite concentrations and SDs.

CONCLUSION

The PRESS technique is relatively insensitive to physiologic brain motion.