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AJNR - American Journal of Neuroradiology

Published ahead of print on March 20, 2008
doi: 10.3174/ajnr.A1001

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Diffusion Tensor Imaging in Chronic Subdural Hematoma: Correlation between Clinical Signs and Fractional Anisotropy in the Pyramidal Tract

K. Yokoyama^a, M. Matsuki^a,b, H. Shimano^a, S. Sumioka^a, T. Ikenaga^a, K. Hanabusa^a, S. Yasuda^a, H. Inoue^a, T. Watanabe^a, M. Miyashita^a,b, R. Hiramatsu^a, K. Murao^a, A. Kondo^a, H. Tanabe^a and T. Kuroiwa^c

^a Department of Neurosurgery, Brain and Spine Surgery Center and Research Institution of Microvascular Decompression, Shiroyama Hospital, Osaka, Japan
^b Department of Radiology, Brain and Spine Surgery Center and Research Institution of Microvascular Decompression, Shiroyama Hospital, Osaka, Japan
^c Department of Neurosurgery, Osaka Medical College, Takatsuki, Osaka, Japan

View larger version (92K): [in this window] [in a new window]   Fig 1. A and B, Head CT and T2-weighted MR images of CSDH, respectively. C and D, Regions of interest in the bilateral pyramidal tract of the cerebral peduncle. C, FA map. D, Apparent diffusion coefficient map.

View larger version (19K): [in this window] [in a new window]   Fig 2. Region-of-interest analysis of FA values in the cerebral peduncle for lesion sides and contralateral sides. The Wilcoxon signed rank test was used for analysis of the differences. A, In patients with CSDH, FA values of the affected sides are significantly lower than those of intact sides (P < .0001). B, In healthy volunteers, there is no significant difference between bilateral sides (P > .5). Lt. indicates left; Rt, right.

View larger version (20K): [in this window] [in a new window]   Fig 3. Region-of-interest analysis of MD values in the cerebral peduncle for lesion sides and contralateral sides. The Wilcoxon signed rank test was used for analysis of the differences. A, In patients with CSDH, there is no significant difference in MD values between the affected sides and the contralateral sides (P > .5). B, In healthy volunteers, there is no significant difference between bilateral sides (P > .5). Lt. indicates left; Rt, right.

View larger version (16K): [in this window] [in a new window]   Fig 4. The correlation between the initial FA ratio and motor weakness. Initial FA ratios are significantly correlated with motor weakness (R2 = 0.32, P = .002) by linear regression analysis. Preope. indicates preoperative.

View larger version (39K): [in this window] [in a new window]   Fig 5. The comparison FA ratios before and after burr-hole craniotomy in 23 patients with CSDH. FA ratios are significantly increased after surgery (Wilcoxon signed rank test, P = .0004). Pre-ope indicates preoperative; Post-ope, postoperative.