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What is Diffusion Tensor Imaging (DTI)?

September 28, 2012 by Steven M. Gursten

How DTI can diagnose concussion and traumatic brain injuries, and help lawyers  explain these injuries to juries when insurance company lawyers deny responsibility and attack TBI victims

The topic of Diffusion Tensor Imaging (DTI) has been coming up a lot lately.  DTI is an imaging scan that helps assess traumatic brain injuries and closed head injuries.  Because car accidents are the leading cause of TBI, it is also a test that lawyers (like myself) who specialize in helping people hurt in  car accidents are seeing more and more often.

To be more specific, DTI is an MRI (magnetic resonance imaging) that measures the way water moves in several directions through the brain’s white matter. The problem with normal MRI is that it is almost always “normal,” even when people are severely impaired from a brain injury. Of course, MRI is also “normal” when people are in comas and when they are dead, which is why defense lawyers love to talk about normal MRIs in court to imply that a person with a TBI can’t be hurt.

But DTI makes it harder for insurance companies and defense lawyers to deny these injuries.  Doctors who treat people with TBI  are talking about DTI now because it is a better tool to diagnose and prove traumatic brain injury, versus the traditional  forms of imaging,  like MRIs and CT scans.

Some types of brain injury and concussions don’t do as much damage to the grey matter in the brain, so neurologists, psychiatrists, and other doctors are looking deeper into the brain, where the white matter is located. To put it simply, the white matter makes up the cables and connections between the sections of the brain. If the white matter is damaged from a car accident, these connections can get disrupted. You can see this through Diffusion Tensor Imaging.

I recently found a great explanation that simplifies DTI for juries, traumatic brain injury lawyers and for accident victims.  It was produced by the  BrainTraumaFoundation.org. Skip to the 3:40 mark, where the doctors in the video start discussing DTI.

Some interesting remarks on DTI from the BrainTrauma video:

“Diffusion Tensor Imaging (DTI) is a new way to bring white matter out of the shadows. Using advanced software to get more detailed information from an MRI image. “When we bring up the DTI, you can really clearly see where the white matter is, and where the grey matter is, because on this, white is white, grey matter is grey.” It’s not only the color that’s important. White matter helps diffuse water through brain cells, and that might be an important clue to what goes wrong in concussions. “So with the DTI, all we’re doing is looking at where water is pretty much. So if the water is not flowing well, it tells you… if you have a leak in the pipe, we’re going to be able to pick that up with the DTI.”

Related information:

Importance of DTI brain scan in brain injury cases

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