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Figure 5–9. Methods of quantitative image analysis.

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Figure 5–9. Methods of quantitative image analysis.This patient sustained a moderate traumatic brain injury (TBI) in a motor vehicle accident. Axial maps created by statistical parametric mapping (SPM) are shown at top left. As can be readily identified on the gradient recalled echo (GRE) sequence shown at top right, there is hemosiderin in the right frontal region (arrow). The T1 anatomical scan is unimpressive with regard to obvious abnormality, but visually the interhemispheric fissure may be more prominent than what would be expected for a teenager, and likewise some of the frontal sulci are prominent. By applying quantitative analysis (lower right), frontal lobe volume is almost a standard deviation below a control sample of similarly aged individuals, supporting the clinical impression of some frontal atrophy. Voxel-based morphology (VBM) analyses clearly demonstrate that the extent of atrophic change in both white matter (WM) and gray matter (GM) concentration in and around the hemosiderin-defined shear lesion is actually considerably greater than that shown on the GRE sequence where just the hemosiderin deposit can be visualized. The VBM map superimposes the location of the WM and GM abnormalities on a standard 3-D surface magnetic resonance imaging brain reconstruction.

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