Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Preoperative Weakness and Demyelination of the Corticospinal Tract in Meningioma Patients : Changes in Diffusion Parameters Using Diffusion Tensor Imaging

  • Kim, Myoung Soo (Department of Neurosurgery, Seoul Paik Hospital, Inje University College of Medicine) ;
  • Chung, Chun Kee (Department of Neurosurgery, Seoul National University College of Medicine) ;
  • Jung, Hee-Won (Department of Neurosurgery, Seoul National University College of Medicine) ;
  • Park, Chul-Kee (Department of Neurosurgery, Seoul National University College of Medicine) ;
  • Kim, Chi Heon (Department of Neurosurgery, Seoul National University College of Medicine) ;
  • Kim, June Sic (Department of Neurosurgery, Seoul National University College of Medicine)
  • Received : 2013.09.02
  • Accepted : 2014.02.13
  • Published : 2014.05.28
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Abstract

Objective : Differentiation of demyelination in white matter from axonal damage can be determined using diffusion tensor imaging (DTI). In this study using meningioma patients an attempt was made to evaluate the relationship between preoperative weakness and the changes of diffusion parameters in the corticospinal tract (CST) using DTI. Methods : Twenty-six patients with meningioma were enrolled in this study. Eleven of them suffered from objective motor weakness and were classified as Group 1. The remaining 15 patients did not present motor weakness and were classified as Group 2. Fiber tractography and CST diffusion parameters were obtained using DTIStudio. The ratios (lesion side mean value/contralateral side mean value) of CST diffusion parameters were compared with 1.0 as a test value using a one-sample t-test. Results : In Group 1, fractional anisotropy (FA), tensor trace (TT), and radial diffusivity (RD, ${\lambda}2$ and ${\lambda}3$) of the CST were significantly different between two hemispheres, but axial diffusivity (AD, ${\lambda}1$) of the CST was not significantly different between two hemispheres. In Group 2, FA and ${\lambda}3$ of CST did not differ significantly between the hemispheres. In Group 2, TT, ${\lambda}1$, and ${\lambda}2$ of CST in the ipsilateral hemisphere were significantly higher than those of the unaffected hemisphere. However, the differences were small. Conclusion : Motor weakness was related to a low FA and high TT resulting from increased RD of the CST fibers. CST diffusion changes in patients with weakness are similar to those for demyelination.

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References

  1. Bello L, Gambini A, Castellano A, Carrabba G, Acerbi F, Fava E, et al. : Motor and language DTI Fiber Tracking combined with intraoperative subcortical mapping for surgical removal of gliomas. Neuroimage 39 : 369-382, 2008 https://doi.org/10.1016/j.neuroimage.2007.08.031
  2. Berman JI, Mukherjee P, Partridge SC, Miller SP, Ferriero DM, Barkovich AJ, et al. : Quantitative diffusion tensor MRI fiber tractography of sensorimotor white matter development in premature infants. Neuroimage 27 : 862-871, 2005 https://doi.org/10.1016/j.neuroimage.2005.05.018
  3. Budde MD, Xie M, Cross AH, Song SK : Axial diffusivity is the primary correlate of axonal injury in the experimental autoimmune encephalomyelitis spinal cord : a quantitative pixelwise analysis. J Neurosci 29 : 2805-2813, 2009 https://doi.org/10.1523/JNEUROSCI.4605-08.2009
  4. Field AS, Alexander AL, Wu YC, Hasan KM, Witwer B, Badie B : Diffusion tensor eigenvector directional color imaging patterns in the evaluation of cerebral white matter tracts altered by tumor. J Magn Reson Imaging 20 : 555-562, 2004 https://doi.org/10.1002/jmri.20169
  5. Helton KJ, Phillips NS, Khan RB, Boop FA, Sanford RA, Zou P, et al. : Diffusion tensor imaging of tract involvement in children with pontine tumors. AJNR Am J Neuroradiol 27 : 786-793, 2006
  6. Kim CH, Chung CK, Kim JS, Jahng TA, Lee JH, Song IC : Use of diffusion tensor imaging to evaluate weakness. J Neurosurg 106 : 111-118, 2007 https://doi.org/10.3171/jns.2007.106.1.111
  7. Loy DN, Kim JH, Xie M, Schmidt RE, Trinkaus K, Song SK : Diffusion tensor imaging predicts hyperacute spinal cord injury severity. J Neurotrauma 24 : 979-990, 2007 https://doi.org/10.1089/neu.2006.0253
  8. Mori S, Frederiksen K, van Zijl PC, Stieltjes B, Kraut MA, Solaiyappan M, et al. : Brain white matter anatomy of tumor patients evaluated with diffusion tensor imaging. Ann Neurol 51 : 377-380, 2002 https://doi.org/10.1002/ana.10137
  9. Nagesh V, Tsien CI, Chenevert TL, Ross BD, Lawrence TS, Junick L, et al. : Radiation-induced changes in normal-appearing white matter in patients with cerebral tumors : a diffusion tensor imaging study. Int J Radiat Oncol Biol Phys 70 : 1002-1010, 2008 https://doi.org/10.1016/j.ijrobp.2007.08.020
  10. Nilsson D, Rutka JT, Snead OC 3rd, Raybaud CR, Widjaja E : Preserved structural integrity of white matter adjacent to low-grade tumors. Childs Nerv Syst 24 : 313-320, 2008 https://doi.org/10.1007/s00381-007-0466-7
  11. Okada T, Mikuni N, Miki Y, Kikuta K, Urayama S, Hanakawa T, et al. : Corticospinal tract localization : integration of diffusion-tensor tractography at 3-T MR imaging with intraoperative white matter stimulation mapping--preliminary results. Radiology 240 : 849-857, 2006 https://doi.org/10.1148/radiol.2403050916
  12. Reich DS, Smith SA, Jones CK, Zackowski KM, van Zijl PC, Calabresi PA, et al. : Quantitative characterization of the corticospinal tract at 3T. AJNR Am J Neuroradiol 27 : 2168-2178, 2006
  13. Salat DH, Tuch DS, Greve DN, van der Kouwe AJ, Hevelone ND, Zaleta AK, et al. : Age-related alterations in white matter microstructure measured by diffusion tensor imaging. Neurobiol Aging 26 : 1215-1227, 2005 https://doi.org/10.1016/j.neurobiolaging.2004.09.017
  14. Schonberg T, Pianka P, Hendler T, Pasternak O, Assaf Y : Characterization of displaced white matter by brain tumors using combined DTI and fMRI. Neuroimage 30 : 1100-1111, 2006 https://doi.org/10.1016/j.neuroimage.2005.11.015
  15. Smits M, Vernooij MW, Wielopolski PA, Vincent AJ, Houston GC, van der Lugt A : Incorporating functional MR imaging into diffusion tensor tractography in the preoperative assessment of the corticospinal tract in patients with brain tumors. AJNR Am J Neuroradiol 28 : 1354-1361, 2007 https://doi.org/10.3174/ajnr.A0538
  16. Song SK, Sun SW, Ju WK, Lin SJ, Cross AH, Neufeld AH : Diffusion tensor imaging detects and differentiates axon and myelin degeneration in mouse optic nerve after retinal ischemia. Neuroimage 20 : 1714-1722, 2003 https://doi.org/10.1016/j.neuroimage.2003.07.005
  17. Song SK, Sun SW, Ramsbottom MJ, Chang C, Russell J, Cross AH : Dysmyelination revealed through MRI as increased radial (but unchanged axial) diffusion of water. Neuroimage 17 : 1429-1436, 2002 https://doi.org/10.1006/nimg.2002.1267
  18. Stadlbauer A, Ganslandt O, Buslei R, Hammen T, Gruber S, Moser E, et al. : Gliomas : histopathologic evaluation of changes in directionality and magnitude of water diffusion at diffusion-tensor MR imaging. Radiology 240 : 803-810, 2006 https://doi.org/10.1148/radiol.2403050937
  19. Warlop NP, Achten E, Fieremans E, Debruyne J, Vingerhoets G : Transverse diffusivity of cerebral parenchyma predicts visual tracking performance in relapsing-remitting multiple sclerosis. Brain Cogn 71 : 410-415, 2009 https://doi.org/10.1016/j.bandc.2009.05.004
  20. Yasmin H, Aoki S, Abe O, Nakata Y, Hayashi N, Masutani Y, et al. : Tract-specific analysis of white matter pathways in healthy subjects : a pilot study using diffusion tensor MRI. Neuroradiology 51 : 831-840, 2009 https://doi.org/10.1007/s00234-009-0580-1

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