Purpose: Functional outcome prediction for patients with traumatic axonal injury (TAI) is not highly related to the MRI classifications. The aim of this study was to assess the accuracy in predicting functional outcome in patients with TAI with several MRI scoring methods and to define the most accurate method.

Methods: Patients with TAI (2008–2014) confirmed on MRI <6 months after injury were included in this retrospective study. Long-term functional outcome was prospectively assessed using the Glasgow Outcome Score Extended. The Gentry classification is most used in clinical practice. This method was compared to methods that score lesion load, lesion locations, and to modified Gentry classifications. The area under the curve (AUC) was calculated for the scoring methods.

Results: A total of 124 patients with TAI were included, medium follow-up 52 months. The AUC for the Gentry classification was 0.64. All tested methods were poor predictors for functional outcome, except for the 6-location score (area under the curve: 0.71). No method was significantly better than the Gentry classification.

Conclusion: The Gentry classification for TAI correlates with functional outcome, but is a poor predictor for the long-term functional outcome. None of the other tested methods was significantly better.

目的：创伤性轴索损伤（TAI）患者的功能预后与MRI分类没有高度关系。这项研究的目的是通过几种MRI评分方法评估TAI患者功能预后的准确性，并定义最准确的方法。

方法：这项回顾性研究纳入了伤后6个月以MRI确诊的TAI患者（2008-2014年）。使用格拉斯哥结果评分扩展对前瞻性评估长期功能结局进行了评估。Gentry分类在临床实践中使用最多。将该方法与对病变负荷，病变部位评分和改良Gentry分类的方法进行了比较。计算曲线下面积（AUC）以进行评分。

结果：共纳入124例TAI患者，中位随访52个月。Gentry分类的AUC为0.64。除6位评分（曲线下面积：0.71）外，所有测试方法均无法预测功能结果。没有一种方法比Gentry分类明显更好。

结论：TAI的Gentry分类与功能预后相关，但对于长期功能预后而言，预测效果较差。其他测试方法均无明显改善。