Suzuki Yuichi, Yagi Kazuo, Kodama Takashi, Shinoura Nobusada
Graduate School of Human Health Sciences, Tokyo Metropolitan University, Arakawa-ku, Tokyo, Japan.
Magn Reson Med Sci. 2009;8(1):9-16. doi: 10.2463/mrms.8.9.
Our goal was to visualize diffusion tensor tractography (DTT) of the corticospinal tract (CST) with areas of activation on functional magnetic resonance imaging (fMRI) to acquire useful, highly accurate preoperative information. We investigated the usefulness of the technique and our method of precisely evaluating the depicted DTT in patients with brain disease.
Nineteen subjects underwent 3-dimensional T(1)-weighted imaging for anatomical reference; gradient-echo, echo-planar imaging (EPI) for fMRI; and single-shot, diffusion-weighted EPI for DTT. The target point for DTT was placed within activated areas in the primary motor area on fMRI, and the seed point was placed in the cerebral peduncle. DTT was depicted with the seed and target points. We examined the precision of DTT using this method by assessing the anteroposterior relationship of depicted DTTs of the upper and lower extremities in the posterior limb of the internal capsule.
DTT was depicted in 18 of 19 cases of the upper extremity and in 12 of 19 cases of the lower extremity. In the evaluation of precision, DTT reflected the posterior limb of the internal capsule in all cases. In terms of the anteroposterior relationship of DTTs, nine of 12 cases showed that fibers in the upper extremities passed in front of fibers in the lower extremities.
This technique allows depiction of DTT associated with a local brain function in the CST in patients with brain disease and may be useful for operative planning. Our method of evaluating precision is also likely to prove useful.
我们的目标是将皮质脊髓束（CST）的扩散张量纤维束成像（DTT）与功能磁共振成像（fMRI）上的激活区域进行可视化，以获取有用的、高度准确的术前信息。我们研究了该技术的实用性以及我们在脑部疾病患者中精确评估所描绘的DTT的方法。
19名受试者接受了三维T（1）加权成像以获取解剖学参考；梯度回波、回波平面成像（EPI）用于fMRI；单次激发扩散加权EPI用于DTT。DTT的目标点置于fMRI上初级运动区的激活区域内，种子点置于大脑脚。通过种子点和目标点描绘DTT。我们通过评估内囊后肢中上肢和下肢所描绘DTT的前后关系，使用该方法检查DTT的精确性。
19例上肢中有18例描绘出DTT，19例下肢中有12例描绘出DTT。在精确性评估中，DTT在所有病例中均反映了内囊后肢。就DTT的前后关系而言，12例中有9例显示上肢纤维走行于下肢纤维前方。
该技术能够描绘脑部疾病患者CST中与局部脑功能相关的DTT，可能对手术规划有用。我们评估精确性的方法也可能证明是有用的。
