Neuroimaging with CT, MRI, and PET-CT of Brain Injuries and Concussions in Contact Sports

George Tsoukatos, BPS, R.T. (R)(ARRT)®

^*Medical Imaging Consultant, Radiology Support Services, Germantown, NY

Address correspondence to: George Tsoukatos, BPS, R.T.(R)(ARRT)^®, Radiology Support Services, PO Box 215, Germantown, NY 12526. E-mail: radiologytechnique@gmail.com.

Disclosure statement: The author reports having no significant financial or advisory relationships with corporate organizations related to this activity.

ABSTRACT

Recently, there has been a growing understanding that all concussions involve some level of brain injury. In addition, few issues in the field of sports medicine have had as high a profile or generated as much public interest as traumatic brain injuries (TBIs) or sports-related concussions. TBIs are clinically divided into a spectrum of severities, with mild traumatic brain injury (mTBI) being the least severe, but with the most frequent occurrence in contact sports. Recently, a long-term consequence of repetitive head injuries like mTBIs has been identified, a chronic neurodegenerative disorder known as chronic traumatic encephalopathy (CTE). CTE has primarily been reported in patients and athletes who engage in combat-like or contact sports as well as military veterans. Despite the increased attention, however, confusion and controversy persist, from how to define a concussion, how repetitive concussions affect the vulnerability of athletes, to future injury progression, and when is it safe for a player to return to the sport. As these recently identified neurologic conditions are seen more frequently, it is important for radiologic technologists who may image patients with this condition be well educated about the anatomy of the brain, these conditions, and how best to perform the necessary imaging studies to diagnose or rule out mTBIs, CTE, and other acute and chronic neurologic conditions. This course will review in detail the anatomy of the skull, the parts of the brain, and the nervous system. It will also provide a review of the basic parts and functionality of the most used modalities employed in neuroimaging, specifically, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography-CT. Definitions and classifications of various forms of TBI and other types head injuries will be outlined and described and visual examples of how these injuries may appear on screen using CT, MRI, and/or PET-CT will be provided. Finally, steps that sports organizations are taking to protect and treat athletes who are susceptible to or may have sustained head injuries will be noted.