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Diffusion tensor imaging (DTI) and tractography of the brachial plexus: feasibility and initial experience in neoplastic conditions

  • Head and Neck Radiology
  • Published:
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Abstract

Introduction

The objective of this study was to assess the feasibility and potential clinical applications of diffusion tensor imaging (DTI) and tractography in the normal and pathologic brachial plexus prospectively.

Methods

Six asymptomatic volunteers and 12 patients with symptoms related to the brachial plexus underwent DTI on a 1.5T system in addition to the routine anatomic plexus imaging protocol. Maps of the apparent diffusion coefficient (ADC) and of fractional anisotropy (FA), as well as tractography of the brachial plexus were obtained. Images were evaluated by two experienced neuroradiologists in a prospective fashion. Three patients underwent surgery, and nine patients underwent conservative medical treatment.

Results

Reconstructed DTI (17/18) were of good quality (one case could not be reconstructed due to artifacts). In all volunteers and in 11 patients, the roots and the trunks were clearly delineated with tractography. Mean FA and mean ADC values were as follows: 0.30 ± 0.079 and 1.70 ± 0.35 mm2/s in normal fibers, 0.22 ± 0.04 and 1.49 ± 0.49 mm2/s in benign neurogenic tumors, and 0.24 ± 0.08 and 1.51 ± 0.52 mm2/s in malignant tumors, respectively. Although there was no statistically significant difference in FA and ADC values of normal fibers and fibers at the level of pathology, tractography revealed major differences regarding fiber architecture. In benign neurogenic tumors (n = 4), tractography revealed fiber displacement alone (n = 2) or fiber displacement and encasement by the tumor (n = 2), whereas in the malignant tumors, either fiber disruption/destruction with complete disorganization (n = 6) or fiber displacement (n = 1) were seen. In patients with fiber displacement alone, surgery confirmed the tractography findings, and excision was successful without sequelae.

Conclusion

Our preliminary data suggest that DTI with tractography is feasible in a clinical routine setting. DTI may demonstrate normal tracts, tract displacement, deformation, infiltration, disruption, and disorganization of fibers due to tumors located within or along the brachial plexus, therefore, yielding additional information to the current standard anatomic imaging protocols.

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Conflict of interest statement

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Neuroradiology, DISIM, Geneva University Hospital, 4 Rue Gabrielle-Perret-Gentil, 1211, Genève 14, Switzerland

    Maria Isabel Vargas, Duy Nguyen & Jacqueline Delavelle

  2. Radiology, Geneva University Hospital and University of Geneva, Geneva, Switzerland

    Magalie Viallon

  3. Unit of Head and Neck Radiology, Geneva University Hospital and University of Geneva, Geneva, Switzerland

    Minerva Becker

Authors
  1. Maria Isabel Vargas
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  2. Magalie Viallon
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  3. Duy Nguyen
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  4. Jacqueline Delavelle
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  5. Minerva Becker
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Correspondence to Maria Isabel Vargas.

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Vargas, M.I., Viallon, M., Nguyen, D. et al. Diffusion tensor imaging (DTI) and tractography of the brachial plexus: feasibility and initial experience in neoplastic conditions. Neuroradiology 52, 237–245 (2010). https://doi.org/10.1007/s00234-009-0643-3

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  • DOI: https://doi.org/10.1007/s00234-009-0643-3

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