DIFFUSION TENSOR TRACTOGRAPHY

医学 偏瘫 磁共振弥散成像 部分各向异性 纤维束成像 磁共振成像 皮质脊髓束 白质 放射科 核医学 血管造影
作者
Wai Hoe Ng,Dennis Lai-Hong Cheong,Kathleen Joy O. Khu,Govidasamy Venkatesh,Yee Kong Ng,C. C. Tchoyoson Lim
出处
期刊:Neurosurgery [Oxford University Press]
卷期号:63 (3): 452-459 被引量:17
标识
DOI:10.1227/01.neu.0000325259.95571.20
摘要

OBJECTIVE Benign extracerebral lesions such as meningiomas may cause hemiparesis by compression and deviation without infiltrating the white matter. We used magnetic resonance diffusion tensor imaging and diffusion tensor tractography to investigate the effects of benign extracerebral lesions on the corticospinal tract (CST). METHODS Thirteen patients with extracerebral lesions (11 benign meningiomas and 2 benign cysts) underwent magnetic resonance diffusion tensor imaging and diffusion tensor tractography of the CST using fiber assignment by continuous tractography. The CST was reconstructed and assessed by comparing the ipsilateral and unaffected contralateral fibers. The tumor volume, relative fractional anisotropy, fiber deviation, relative fiber number, and relative fiber per voxel were compared between patients without and with temporary presurgical hemiparesis. RESULTS Seven patients without hemiparesis and five patients with temporary hemiparesis were analyzed; one patient had permanent weakness and was excluded from analysis. There was no significant difference in the tumor volume, relative fractional anisotropy, presence of cerebral edema, or CST deviation between groups. In patients with temporary hemiparesis, the median relative fiber number (mean, 0.35 ± 0.32) and relative fiber per voxel (mean, 0.49 ± 0.14) were significantly reduced compared with patients without hemiparesis (0.92 ± 0.55, P = 0.04; and 0.96 ± 0.28, P < 0.01, respectively). CONCLUSION In patients with benign extracerebral lesions, reduction in fiber number and fiber per voxel, but not fiber deviation, correlated with temporary hemiparesis. Clinical recovery was possible even if the CST fibers detected by diffusion tensor tractography were reduced by benign extracerebral lesions.
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