To investigate the accuracy of diffusion tensor imaging (DTI) and diffusion tensor imaging tracking (DTT) in prognostic of patients with diffuse axonal injury (DAI).

Thirty-four patients with DAI, admitted to Neurosurgery Department of 988 Hospital Chinese People Liberation Army from January 2016 to January 2018, underwent 3.0T conventional cranial MRI within one week after trauma. DTI and DTT imaging were performed at the same time. According to the number and morphology of fiber bundles, the prognosis of patients was predicted and divided into three levels: level Ⅰ, consciousness recovery with or without disability; level Ⅱ, plant survival; level Ⅲ, clinical death. At the same time, brainstem auditory evoked potential (BAEP) was monitored immediately after injury and completed within 1 week. According to the Cant criteria, the prognosis was predicted and divided into three grades: level Ⅰ, consciousness recovery with or without disability; level Ⅱ, plant survival; level Ⅲ, clinical death. According to the actual results, the coincidence rate of the two methods is compared, and the advantages and disadvantages of the prediction are analyzed.

According to the prediction of DTI and DTT, there were 15 patients in level Ⅰ, 13 patients in level Ⅱ and 6 patients in level Ⅲ. According to the monitoring results of BAEP, there were 8 patients in level Ⅰ, 18 patients in level Ⅱ and 8 patients in level Ⅲ. The accuracy of BAEP was significantly higher than that of DTI and DTT in the prediction of grade Ⅲ outcomes, while the accuracy of DTI and DTT was significantly higher than BAEP in the prediction of grade Ⅰ and Ⅱ outcomes.

DTI, DTT and BAEP have their own advantages in the diagnosis and outcome prediction of diffuse axonal injury.