scholarly journals Diffusion tensor imaging tractography to visualize the relationship of the optic radiation to epileptogenic lesions prior to neurosurgery

Epilepsia ◽  
2011 ◽  
Vol 52 (8) ◽  
pp. 1430-1438 ◽  
Author(s):  
Gavin P. Winston ◽  
Mahinda Yogarajah ◽  
Mark R. Symms ◽  
Andrew W. McEvoy ◽  
Caroline Micallef ◽  
...  
2019 ◽  
Vol 5 (1) ◽  
pp. 59-64
Author(s):  
Jiefei Li ◽  
Le He ◽  
Yuqi Zhang

Objective: To explore the usefulness of multishot diffusion tensor imaging (DTI) for evaluating the neurological function of patients with spinal cord tumors Methods: Routine magnetic resonance imaging and multishot DTI were performed in five patients with spinal cord tumors. The values of fractional anisotropy (FA) and radial diffusivity (RD) were analyzed. Results: Multishot DTI of spinal cord tumors allowed for defining the margins of tumors and determining the relationship of tumors with the adjacent white matter structures of the spinal cord. Multishot DTI demonstrated significantly increased RD and decreased FA of spinal cord tumors compared with those of the normal spinal cord. Conclusions: Multishot DTI is a potentially useful modality for differentiating resectable tumors from nonresectable ones based on preoperative imaging alone as well as for differentiating intramedullary tumors from extramedullary ones. Further prospective studies are warranted to confirm these results.


2011 ◽  
Vol 70 (suppl_2) ◽  
pp. ons290-ons299 ◽  
Author(s):  
Nobuyuki Kaneko ◽  
Warren W. Boling ◽  
Takaharu Shonai ◽  
Kazumi Ohmori ◽  
Yoshiaki Shiokawa ◽  
...  

ABSTRACT BACKGROUND: Surgery within the insula carries significant risk of morbidity, particularly hemiparesis, because of the difficulty in detecting the internal capsule boundaries. OBJECTIVE: We analyzed the anatomy of the insula and identified landmarks anticipated to facilitate surgery for intrinsic insular lesions. METHODS: Insular region anatomy was studied in 11 cadaveric brains harvested within 72 hours postmortem. MRI of the specimens was acquired using 3.0 T with T2-weighting and 25 directions of diffusion tensor imaging. Landmarks easily recognizable during surgery were identified on the surface of the insula. The interrelationships between surface landmarks and critical structures were analyzed. RESULTS: The posterior inferior insular point (PIIP) and the upper central insular point (UCIP) were newly established as landmarks on the insula. The PIIP corresponded to the obvious bend in the posterior long insular gyrus. The UCIP is the meeting point between the central insular sulcus and superior peri-insular sulcus. The corticospinal tract was identified as a high-intensity area in the posterior limb of the internal capsule on T2-weighted imaging and its course confirmed with diffusion tensor imaging tractography. The corticospinal tract took a course deep to the posterosuperior insula on T2-weighted imaging, 4.8 mm from the UCIP and 6.2 mm from the PIIP. CONCLUSION: The posterosuperior part of the insula forms the region at greatest risk to corticospinal tract injury. The PIIP and UCIP are crucial to understanding the relationship of the insula with the posterior limb of the internal capsule including the corticospinal tract.


2011 ◽  
Vol 97 (1-2) ◽  
pp. 124-132 ◽  
Author(s):  
Gavin P. Winston ◽  
Laura Mancini ◽  
Jason Stretton ◽  
Jonathan Ashmore ◽  
Mark R. Symms ◽  
...  

Author(s):  
Shawn D’Souza ◽  
Lisa Hirt ◽  
David R Ormond ◽  
John A Thompson

Abstract Gliomas are neoplasms that arise from glial cell origin and represent the largest fraction of primary malignant brain tumours (77%). These highly infiltrative malignant cell clusters modify brain structure and function through expansion, invasion and intratumoral modification. Depending on the growth rate of the tumour, location and degree of expansion, functional reorganization may not lead to overt changes in behaviour despite significant cerebral adaptation. Studies in simulated lesion models and in patients with stroke reveal both local and distal functional disturbances, using measures of anatomical brain networks. Investigations over the last two decades have sought to use diffusion tensor imaging tractography data in the context of intracranial tumours to improve surgical planning, intraoperative functional localization, and post-operative interpretation of functional change. In this study, we used diffusion tensor imaging tractography to assess the impact of tumour location on the white matter structural network. To better understand how various lobe localized gliomas impact the topology underlying efficiency of information transfer between brain regions, we identified the major alterations in brain network connectivity patterns between the ipsilesional versus contralesional hemispheres in patients with gliomas localized to the frontal, parietal or temporal lobe. Results were indicative of altered network efficiency and the role of specific brain regions unique to different lobe localized gliomas. This work draws attention to connections and brain regions which have shared structural susceptibility in frontal, parietal and temporal lobe glioma cases. This study also provides a preliminary anatomical basis for understanding which affected white matter pathways may contribute to preoperative patient symptomology.


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