Three-dimensional white matter tractography by diffusion tensor imaging in ischaemic stroke involving the corticospinal tract
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Diffusion tensor MR imaging (DTI) provides information on diffusion anisotropy, which can be expressed with three-dimensional (3D) white matter tractography. We used 3D white matter tractography to show the corticospinal tract in eight patients with acute or early subacute ischaemic stroke involving the posterior limb of the internal capsule or corona radiata and to assess involvement of the tract. Infarcts and the tract were shown simultaneously, providing information on their spatial relationships. In five of the eight patients, 3D fibre tract maps showed the corticospinal tract in close proximity to the infarct but not to pass through it. All these patients recovered well, with maximum improvement from the lowest score on manual muscle testing (MMT) up to the full score through rehabilitation. In the other three patients the corticospinal tract was shown running through the infarct; reduction in MMT did not necessarily improve favourably or last longer, other than in one patient. As 3D white matter tractography can show spatial relationships between the corticospinal tract and an infarct, it might be helpful in prognosis of gross motor function.
KeywordsBrain infarcts Magnetic resonance imaging Diffusion tensor imaging Nerve fibres Tractography
We thank K. Ino and Y. Satake for technical advice on image processing.
- 3.Melhem ER, Mori S, Mukundan G, et al (2002) Diffusion tensor MR imaging of the brain and white matter tractography. Am J Roentgenol 178: 3–16Google Scholar
- 6.Masutani Y, Abe O, Aoki S, et al (2002) Tractography of brain white matter tracts based on analysis of MR diffusion tensor data: selective tractography with tracking reliability. Med Imag Tech 20: 584–592 [Japanese]Google Scholar
- 9.Victor M, Ropper AH (2001) Principles of neurology. McGraw-Hill, New York, pp 47–66Google Scholar
- 11.Victor M and Ropper AH (2001) Principles of neurology. McGraw-Hill, New York, pp 821-924Google Scholar