Advance in Diffusion Tensor Imaging in Assessment of White Matter Fiber Tracts Injury and Prognosis of Stroke(rerview)
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Diffusion tensor imaging (DTI) could not only reconstruct of the brain white matter neural connectivity,but also show clearly the brain white matter fiber morphology of lesions,either directly or indirectly,which imaged on white matter fiber tracts in the three-dimensional geometric structure by special software for image on the anisotropic thermal motion of water molecules.This paper reviewed the researches on DTI in the assessment of white matter fiber tracts injury and prognosis in patients with stroke.Keywords:
Fiber tract
Stroke
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Surgical Planning
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Stroke as one the most significant health problems can be diagnosed by clinical symptoms and medical imaging modalities. Stroke patients mostly suffer from white matter changes, so the detection of any change in the white matter is important in that the white matter is directly affecting the brain functions. Diffusion tensor imaging, which allows the determination of the microstructural properties of white matter noninvasively yields to extract the tissue changes due to pathology. This study focuses on the brain areas of patients affected by thalamic stroke using the brain fiber tracts' distribution which allows the quantitative tracking of white matter changes. Besides the comparison of the stroke patients with the healthy control group, variations in white matter volume and the fiber tract distribution between the right and left thalamic stroke cases are also computed in a voxel-wise manner. The statistical analyses result that in thalamic stroke patients, the total number of voxels with white matter and the total volume of white matter have been decreased with respect to controls. The developed spatial masks aid to investigate the structural properties of the stroke whether it's in the right or left side of thalamus. Results allow one to discuss the voxel statistics of thalamic stroke cases and subjectwise comparison of the same fibers.
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Corticospinal tract
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Diffusion tensor imaging is unique in its ability to non-invasively visualize white matter fiber tracts in the human brain in vivo. White matter fiber bundles of the human brain form a spatial defined by the anatomical and functional architecture. Determination of axonal pathways provides an invaluable means to study the connectivity of human brain and its functional network. Comparison of fiber tract properties across subjects requires comparison at corresponding anatomical locations. In this paper, we present application of white matter tractography method based on incoherent motion of water molecules in fiber tissue, mainly in central nervous system. This motion is itself dependent on the micro-structural environment that restricts the movement of the water molecules. In white matter fibers there is a pronounced directional dependence on diffusion. With white matter fiber tracking or tractography, projections among brain regions can be detected in the three-dimentional diffusion tensor dataset according to the directionality of the fibers. The authors indicate diagnostic possibilities of MR tractography in otolaryngology for imaging the nervous tracts of sense of hearing, smell and taste with particular consideration of otoneurological evaluation of patients with cochlear implants and bone anchored hearing aid (BAHA). White matter tracts can be evaluated independently by using diffusion tensor tractography, which appears to be a promising technique for determining changes in white matter in degenerative disease. The authors also indicate that method as a beneficial in the surgical planning for patients with intrinsic brain tumors.
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Abstract We applied multislice, whole‐brain diffusion tensor imaging (DTI) to two patients with anaplastic astrocytoma. Data were analyzed using DTI‐based, color‐coded images and a 3‐D tract reconstruction technique for the study of altered white matter anatomy. Each tumor was near two major white matter tracts, namely, the superior longitudinal fasciculus and the corona radiata. Those tracts were identified using the color‐coded maps, and spatial relationships with the tumors were characterized. In one patient the tumor displaced adjacent white matter tracts, whereas in the other it infiltrated the superior longitudinal fasciclus without displacement of white matter. DTI provides new information regarding the detailed relationship between tumor growth and nearby white matter tracts, which may be useful for preoperative planning.
Inferior longitudinal fasciculus
Superior longitudinal fasciculus
Corona radiata (embryology)
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Background: Diffusion tensor imaging (DTI) is a magnetic resonance–based imaging technique that can provide important information about the underlying structure and integrity of the white matter in the brain. Tractography, a DTI postprocessing technique, can provide a detailed model of individual white matter fiber tracts. Knowledge of these tracts may be beneficial in the surgical planning and execution for neurosurgical patients. Case Report: We review the basic principles behind DTI and present an illustrative case in which DTI was used to delineate the relationship of eloquent white matter tracts to a cavernous malformation in a patient undergoing resection. Conclusion: The use of DTI during preoperative planning allows the neurosurgeon to understand if a lesion is disrupting, infiltrating, or altering the course of local white matter tracts. With the combined use of DTI and intraoperative neuronavigation, the neurosurgeon can better identify and avoid white matter tracts, not only in the local area of resection but also during approach to the lesion, thereby reducing the risk of damage to vital cortical pathways and subsequent functional impairment.
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Recent advances in magnetic resonance (MR) diffusion tensor imaging technique enable evaluation of the anisotropy of white matter tracts in-vivo, as well as the integrity of fibre tracts and their orientation. We describe our initial experiences with diffusion tensor imaging and MR tractography techniques to evaluate the structural degeneration of white matter tracts following stroke.Diffusion tensor imaging data were acquired in 11 cases with stroke on a 3T MR imaging scanner, with three-dimensional diffusion tensor imaging-based colour maps and MR tractography performed offline. We evaluated the spatial relationships of the eloquent white matter tracts to the infarcts and areas of haemorrhage, and classified therewith the tracts as either disrupted or displaced. We compared these with the clinical severity of the neurological deficits and prognosis.A good correlation was found between tractography findings and patient's clinical recovery. All the patients with disruption of white matter tracts had residual deficits on clinical follow-up, whereas the patients with displaced tracts had near complete neurological recovery.Diffusion tensor imaging and MR tractography provide a novel and useful method to directly visualise changes in the white matter tracts in stroke. This can potentially allow clinical-imaging correlation with prognostic potential.
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Fiber Tracking法を用いた白質線維描出は,中枢神経疾患の診断および治療戦略を考慮するうえで重要な手法となってきた.この方法に関して,関心領域をどう設定するか,神経線維交叉部や浮腫の中での線維描出をどう描出するかといった問題点が報告されている.われわれはこの方法を用いて,頭蓋内腫瘤性病変178例に対して白質線維描出を行った.その結果,線維が大きな腫瘤性病変に沿って描出されることがあること,関心領域の始点と終点を入れ替えることにより線維描出パターンが大きく変化することの2点が問題点として確認された.本法はまだ開発段階の検査方法であり,問題点の解明と検証操作が必要であると考えられる。
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