Quantification of Corticospinal Tracts with Diffusion Tensor Imaging in Brainstem Surgery: Prognostic Value in 14 Consecutive Cases at 3T Magnetic Resonance Imaging
Abstract
In this study, we investigated the potential prognostic role of morphologic and quantitative diffusion tensor imaging (DTI) in patients with brainstem cavernoma (BSC) in terms of postoperative outcome. In this retrospective study of 14 brainstem cavernoma patients, we analyzed pre- and postoperative DTI data. White matter tractography of corticospinal tracts (CSTs) was performed with the Fiber Assignment by Continuous Tracking algorithm, and morphologic characteristics of CSTs were compared with clinically assessed motor strength. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were measured in ipsi- and contralesional regions of interest at the lesion level, as well as levels caudal and rostral to the lesion. Correlation analysis was performed between lateral index (LI) of ipsi-/contralateral FA and ADC values and patients' motor function. Preoperatively, normal morphologic features of CSTs corresponded to normal motor function in 4 patients. The other 10 morphologically abnormal preoperative CSTs didn't show corresponding motor impairment either in pre- or postoperative follow-up period. The sensitivity, specificity, positive predictive, and negative predictive values of white matter tractographic morpholo...Continue Reading
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