Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China.
Department of Neurosurgery, Fujian Medical University Union Hospital, Fuzhou, China.
Korean J Radiol. 2021 May;22(5):759-769. doi: 10.3348/kjr.2020.0949. Epub 2020 Nov 30.
To evaluate the application of laplacian-regularized mean apparent propagator (MAPL)-MRI to brain glioma-induced corticospinal tract (CST) injury.
This study included 20 patients with glioma adjacent to the CST pathway who had undergone structural and diffusion MRI. The entire CSTs of the affected and healthy sides were reconstructed, and the peritumoral CSTs were manually segmented. The morphological characteristics of the CST (track number, average length, volume, displacement of the affected CST) were examined and the diffusion parameter values, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD), mean squared displacement (MSD), q-space inverse variance (QIV), return-to-origin probability (RTOP), return-to-axis probabilities (RTAP), and return-to-plane probabilities (RTPP) along the entire and peritumoral CSTs, were calculated. The entire and peritumoral CST characteristics of the affected and healthy sides as well as those relative CST characteristics of the patients with motor weakness and normal motor function were compared.
The track number, volume, MD, RD, MSD, QIV, RTAP, RTOP, and RTPP of the entire and peritumoral CSTs changed significantly for the affected side, whereas the AD and FA changed significantly only in the peritumoral CST ( < 0.05). In patients with motor weakness, the relative MSD of the entire CST, QIV of the entire and peritumoral CSTs, and the AD, MD, RD of the peritumoral CST were significantly higher, whereas the RTPP of the entire and peritumoral CSTs and the RTOP of the peritumoral CST were significantly lower than those in patients with normal motor function ( < 0.05 for all). In contrast, no significant changes were found in the CST morphological characteristics, FA, or RTAP ( > 0.05 for all).
MAPL-MRI is an effective approach for evaluating microstructural changes after CST injury. Its sensitivity may improve when using the peritumoral CST features.
评估拉普拉斯正则化平均表观扩散系数（MAPL）-MRI 在脑胶质瘤诱导的皮质脊髓束（CST）损伤中的应用。
本研究纳入 20 例 CST 通路上邻近脑胶质瘤患者，均行结构 MRI 和弥散 MRI 检查。重建患侧和健侧 CST 全长，手动勾画 CST 肿瘤周围区。分析 CST 全长形态学特征（束数、平均长度、体积、患侧 CST 移位），并测量弥散参数值，包括各向异性分数（FA）、平均弥散系数（MD）、轴向弥散系数（AD）、径向弥散系数（RD）、均方根位移（MSD）、q-space 倒数方差（QIV）、返归原点概率（RTOP）、返归轴概率（RTAP）、返归平面概率（RTPP），并比较患侧和健侧全长及肿瘤周围区 CST 特征值，比较运动功能障碍组和运动功能正常组患者相对 CST 特征值。
患侧 CST 全长及肿瘤周围区各向异性分数 FA、AD、MD、RD、MSD、QIV、RTAP、RTOP、RTPP 差异均有统计学意义（ < 0.05），而 AD 仅在肿瘤周围区、MD、RD 仅在全长 CST 差异有统计学意义（ < 0.05）。运动功能障碍组患者 CST 全长相对 MSD、全长及肿瘤周围区 QIV、肿瘤周围区 AD、MD、RD 均高于运动功能正常组（ < 0.05），而全长及肿瘤周围区 RTPP、肿瘤周围区 RTOP 均低于运动功能正常组（ < 0.05）。而 CST 全长形态学特征、FA、RTAP 差异均无统计学意义（ > 0.05）。
MAPL-MRI 是一种评估 CST 损伤后微观结构变化的有效方法，其对肿瘤周围区 CST 特征的敏感度可能更高。
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