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AJNR - American Journal of Neuroradiology

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Diffusion Tensor Imaging of the Corticospinal Tract before and after Mass Resection as Correlated with Clinical Motor Findings: Preliminary Data

Bryan J. Laundre^a, Brian J. Jellison^a, Behnam Badie^b, Andrew L. Alexander^c,d and Aaron S. Field^a

^a Department of Radiology, University of Wisconsin Medical School, Madison
^b Department of Neurological Surgery, University of Wisconsin Medical School, Madison
^c Department of Medical Physics, University of Wisconsin Medical School, Madison
^d Department of Psychiatry, University of Wisconsin Medical School, Madison

View larger version (76K): [in a new window]   FIG 1. Patient 1. Preoperative (A–C) and postoperative (D–F) axial images of a right thalamic pilocytic astrocytoma: contrast-enhanced T1-weighted images (A and D), T2-weighted images (B and E), and directional color maps (C and F). Before surgery, DTI reveals decreased FA (diminished blue in C) and posteromedial displacement of the right PLIC (arrow in C). After surgery, DTI shows persistently decreased FA and displacement of the right PLIC (arrowhead in F).

View larger version (76K): [in a new window]   FIG 2. Patient 2. Preoperative (A–C) and postoperative (D–F) axial images of a left frontal pilocytic astrocytoma: contrast-enhanced T1-weighted images (A and D), T2-weighted images (B and E), and directional color maps (C and F). Before surgery, DTI reveals decreased FA (diminished blue in C) and posteromedial displacement of the left PLIC (arrow in C). After surgery, DTI shows both restored FA (normal blue in F) and normal positioning of the left PLIC.

View larger version (77K): [in a new window]   FIG 3. Patient 3. Preoperative (A–C) and postoperative (D–F) axial images of a left thalamic ganglioglioma: contrast-enhanced T1-weighted images (A and D), T2-weighted images (B and E), and directional color maps (C and F). Before surgery, DTI reveals lateral displacement of the left PLIC (arrow in C); after surgery, DTI shows that the position has returned to normal.

View larger version (73K): [in a new window]   FIG 4. Patient 4. Preoperative (A–C) and postoperative (D–F) axial images of the right striatal hemorrhagic cavernous angioma: contrast-enhanced T1-weighted images (A and D), T2-weighted images (B and E), and directional color maps (C and F). Before surgery, DTI reveals only slight displacement of the right PLIC. After surgery, DTI shows a preserved right PLIC.

View larger version (62K): [in a new window]   FIG 5. Patient 1. Axial images of the brainstem. Before (A) and after (C) surgery, conventional T2-weighted images show subtle blunting of the right ventral surface of the pons (arrow). Preoperative (B) and postoperative (D) DTI reveals marked diminution of the CST in the right ventral pons, consistent with wallerian degeneration (arrowhead).