Department of Molecular Biology, University of Colorado, Boulder, CO, United States of America.
Department of Neurosurgery, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America.
PLoS One. 2019 Nov 21;14(11):e0225323. doi: 10.1371/journal.pone.0225323. eCollection 2019.
Gliomas account for 26.5% of all primary central nervous system tumors. Recent studies have used diffusion tensor imaging (DTI) to extract white matter fibers and the diffusion coefficients derived from MR processing to provide useful, non-invasive insights into the extent of tumor invasion, axonal integrity, and gross differentiation of glioma from metastasis. Here, we extend this work by examining whether a tract-based analysis can improve non-invasive localization of tumor impact on white matter integrity. This study retrospectively analyzed preoperative magnetic resonance sequences highlighting contrast enhancement and DTI scans of 13 subjects that were biopsy-confirmed to have either high or low-grade glioma. We reconstructed the corticospinal tract and superior longitudinal fasciculus by applying atlas-based regions of interest to fibers derived from whole-brain deterministic streamline tractography. Within-subject comparison of hemispheric diffusion coefficients (e.g., fractional anisotropy and mean diffusivity) indicated higher levels of white matter degradation in the ipsilesional hemisphere. Novel application of along-tract analyses revealed that tracts traversing the tumor region showed significant white matter degradation compared to the contralesional hemisphere and ipsilesional tracts displaced by the tumor.
神经胶质瘤占所有原发性中枢神经系统肿瘤的 26.5%。最近的研究使用弥散张量成像（DTI）提取白质纤维和从磁共振处理中得出的扩散系数，为肿瘤侵袭程度、轴突完整性以及神经胶质瘤与转移瘤的大体分化提供了有用的、非侵入性的见解。在这里，我们通过检查基于束路径的分析是否可以改善肿瘤对白质完整性影响的非侵入性定位来扩展这项工作。本研究回顾性分析了术前磁共振序列，重点是 13 名经活检证实患有高级或低级神经胶质瘤的受试者的对比增强和弥散张量成像扫描。我们通过将基于图谱的感兴趣区域应用于全脑确定性流线追踪纤维，重建了皮质脊髓束和上纵束。对侧半球的弥散系数（如各向异性分数和平均弥散度）的半球内比较表明，病变侧半球的白质降解程度更高。沿束路径的新分析应用表明，与对侧半球和肿瘤移位的同侧束相比，穿过肿瘤区域的束显示出明显的白质降解。
