Optimal Factors of Diffusion Tensor Imaging Predicting Corticospinal Tract Injury in Patients with Brain Tumors

다국어 초록 (Multilingual Abstract)

Objective: To identify the optimal factors in diffusion tensor imaging for predicting corticospinal tract (CST) injury caused by brain tumors.
Materials and Methods: This prospective study included 33 patients with motor weakness and 64 patients with normal motor function. The movement of the CST, minimum distance between the CST and the tumor, and relative fractional anisotropy (rFA) of the CST on diffusion tensor imaging, were compared between patients with motor weakness and normal function. Logistic regression analysis was used to obtain the optimal factor predicting motor weakness.
Results: In patients with motor weakness, the displacement (8.44 ± 6.64 mm) of the CST (p = 0.009), minimum distance (3.98 ± 7.49 mm) between the CST and tumor (p < 0.001), and rFA (0.83 ± 0.11) of the CST (p < 0.001) were significantly different from those of the normal group (4.64 ± 6.65 mm, 14.87 ± 12.04 mm, and 0.98 ± 0.05, respectively) (p = 0.009, p < 0.001, and p < 0.001). The frequencies of patients with the CST passing through the tumor (6%, p = 0.002), CST close to the tumor (23%, p < 0.001), CST close to a malignant tumor (high grade glioma, metastasis, or lymphoma) (19%, p < 0.001), and CST passing through infiltrating edema (19%, p < 0.001) in the motor weakness group, were significantly different from those of the patients with normal motor function (0, 8, 1, and 10%, respectively). Logistic regression analysis showed that decreased rFA and CST close to a malignant tumor were effective variables related to motor weakness.
Conclusion: Decreased fractional anisotropy, combined with closeness of a malignant tumor to the CST, is the optimal factor in predicting CST injury caused by a brain tumor.

참고문헌 (Reference)

1 Clark CA, "White matter fiber tracking in patients with space-occupying lesions of the brain: a new technique for neurosurgical planning?" 20 : 1601-1608, 2003

2 Puig J, "Wallerian degeneration in the corticospinal tract evaluated by diffusion tensor imaging correlates with motor deficit 30 days after middle cerebral artery ischemic stroke" 31 : 1324-1330, 2010

3 Itagiba VGA, "Use of diffusion tensor magnetic resonance imaging in the assessment of patterns of white matter involvement in patients with brain tumors: is it useful in the differential diagnosis?" 43 : 362-368, 2010

4 Kim CH, "Use of diffusion tensor imaging to evaluate weakness" 106 : 111-118, 2007

5 Yamada K, "The pyramidal tract has a predictable course through the centrum semiovale: a diffusion-tensor based tractography study" 26 : 519-524, 2007

6 Zolal A, "The effect of a gadolinium-based contrast agent on diffusion tensor imaging" 81 : 1877-1882, 2012

7 Reich DS, "Quantitative characterization of the corticospinal tract at 3T" 27 : 2168-2178, 2006

8 Myoung Soo Kim, "Preoperative Weakness and Demyelination of the Corticospinal Tract in Meningioma Patients : Changes in Diffusion Parameters Using Diffusion Tensor Imaging" 대한신경외과학회 55 (55): 267-272, 2014

9 Cuthbert SC, "On the reliability and validity of manual muscle testing: a literature review" 15 : 4-, 2007

10 Yamahara T, "Morphological and flow cytometric analysis of cell infiltration in glioblastoma: a comparison of autopsy brain and neuroimaging" 27 : 81-87, 2010

11 Goebell E, "Low-grade and anaplastic gliomas: differences in architecture evaluated with diffusion-tensor MR imaging" 239 : 217-222, 2006

12 Mathias J, "Giant cystic widening of Virchow-Robin spaces: an anatomofunctional study" 28 : 1523-1525, 2007

13 김민재, "Emerging Techniques in Brain Tumor Imaging: What Radiologists Need to Know" 대한영상의학회 17 (17): 598-619, 2016

14 Bae MS, "Effect of intravenous gadolinium-DTPA on diffusion tensor MR imaging for the evaluation of brain tumors" 51 : 793-802, 2009

15 Min ZG, "Does diffusion tensor tractography of the corticospinal tract correctly reflect motor function?" 23 : 174-176, 2014

16 Berman JI, "Diffusiontensor imaging-guided tracking of fibers of the pyramidal tract combined with intraoperative cortical stimulation mapping in patients with gliomas" 101 : 66-72, 2004

17 Ng WH, "Diffusion tensor tractography: corticospinal tract fiber reduction is associated with temporary hemiparesis in benign extracerebral lesions" 63 : 452-458, 2008

18 Yu CS, "Diffusion tensor tractography in patients with cerebral tumors: a helpful technique for neurosurgical planning and postoperative assessment" 56 : 197-204, 2005

19 De Belder FE, "Diffusion tensor imaging provides an insight into the microstructure of meningiomas, high-grade gliomas, and peritumoral edema" 36 : 577-582, 2012

20 Morita N, "Diffusion tensor imaging of the corticospinal tract in patients with brain neoplasms" 10 : 239-243, 2011

21 Laundre BJ, "Diffusion tensor imaging of the corticospinal tract before and after mass resection as correlated with clinical motor findings:preliminary data" 26 : 791-796, 2005

22 Young RJ, "Diffusion tensor imaging and tractography of the corticospinal tract in the presence of enlarged Virchow-Robin spaces" 24 : 79-82, 2014

23 Stadlbauer A, "Diffusion tensor imaging and optimized fiber tracking in glioma patients: histopathologic evaluation of tumor-invaded white matter structures" 34 : 949-956, 2007

24 Schlüter M, "Detection of tumour infiltration in axonal fibre bundles using diffusion tensor imaging" 1 : 80-86, 2005

25 Hendler T, "Delineating gray and white matter involvement in brain lesions: three-dimensional alignment of functional magnetic resonance and diffusion-tensor imaging" 99 : 1018-1027, 2003

26 Kwon YH, "Combined study of transcranial magnetic stimulation and diffusion tensor tractography for prediction of motor outcome in patients with corona radiata infarct" 43 : 430-434, 2011

27 Stadlbauer A, "Changes in fiber integrity, diffusivity, and metabolism of the pyramidal tract adjacent to gliomas: a quantitative diffusion tensor fiber tracking and MR spectroscopic imaging study" 28 : 462-469, 2007

28 Mori S, "Brain white matter anatomy of tumor patients evaluated with diffusion tensor imaging" 51 : 377-380, 2002

29 Yamada K, "Brain fiber tracking with clinically feasible diffusion-tensor MR imaging: initial experience" 227 : 295-301, 2003

30 Kovanlikaya I, "Assessment of the corticospinal tract alterations before and after resection of brainstem lesions using diffusion tensor imaging (DTI) and tractography at 3T" 77 : 383-391, 2011

31 Bagadia A, "Application of magnetic resonance tractography in the perioperative planning of patients with eloquent region intra-axial brain lesions" 18 : 633-639, 2011

32 Dimou S, "A systematic review of functional magnetic resonance imaging and diffusion tensor imaging modalities used in presurgical planning of brain tumour resection" 36 : 205-214, 2013