Fernández-Miranda Juan C, Rhoton Albert L, Alvarez-Linera Juan, Kakizawa Yukinari, Choi Chanyoung, de Oliveira Evandro P
Department of Neurosurgery, University of Florida, Gainesville, Florida, USA.
Neurosurgery. 2008 Jun;62(6 Suppl 3):989-1026; discussion 1026-8. doi: 10.1227/01.neu.0000333767.05328.49.
We sought to investigate the three-dimensional structure of the white matter of the brain by means of the fiber-dissection technique and diffusion-tensor magnetic resonance imaging to assess the usefulness of the combination of both techniques, compare their results, and review the potential functional role of fiber tracts.
Fifteen formalin-fixed human hemispheres were dissected according to Klingler's fiber-dissection technique with the aid of 36 to 340 magnification. Three-dimensional anatomic images were created with the use of specific software. Two hundred patients with neurological symptoms and five healthy volunteers were studied with diffusion-tensor magnetic resonance imaging (3 T) and tractographic reconstruction.
The most important association, projection, and commissural fasciculi were identified anatomically and radiologically. Analysis of their localization, configuration, and trajectory was enhanced by the combination of both techniques. Three-dimensional anatomic reconstructions provided a better perception of the spatial relationships among the white matter tracts. Tractographic reconstructions allowed for inspection of the relationships between the tracts as well as between the tracts and the intracerebral lesions. The combination of topographical anatomic studies of human fiber tracts and neuroanatomic research in experimental animals, with data from the clinicoradiological analysis of human white matter lesions and intraoperative subcortical stimulation, aided in establishing the potential functional role of the tracts.
The fiber-dissection and diffusion-tensor magnetic resonance imaging techniques are reciprocally enriched not only in their application to the study of the complex intrinsic architecture of the brain, but also in their practical use for diagnosis and surgical planning.
我们试图通过纤维解剖技术和扩散张量磁共振成像来研究脑白质的三维结构，以评估这两种技术联合使用的有效性，比较它们的结果，并探讨纤维束的潜在功能作用。
15个用福尔马林固定的人类大脑半球按照克林格勒纤维解剖技术进行解剖，借助36至340倍放大倍数。使用特定软件创建三维解剖图像。对200例有神经症状的患者和5名健康志愿者进行扩散张量磁共振成像（3T）和纤维束成像重建研究。
从解剖学和放射学上识别出了最重要的联合、投射和连合纤维束。两种技术联合使用增强了对其定位、形态和走行的分析。三维解剖重建能更好地感知白质纤维束之间的空间关系。纤维束成像重建有助于检查纤维束之间以及纤维束与脑内病变之间的关系。将人类纤维束的地形解剖学研究与实验动物的神经解剖学研究相结合，并结合人类白质病变的临床放射学分析数据和术中皮质下刺激，有助于确定纤维束的潜在功能作用。
纤维解剖技术和扩散张量磁共振成像技术不仅在应用于研究脑的复杂内在结构方面相互丰富，而且在诊断和手术规划的实际应用中也相互丰富。
