Stroke patients' evolving symptoms assessed by tractography.
OBJECTIVE
To test the hypothesis that an interval evolution in the location of the depicted sensorimotor tract relative to the infarct (the "tract-infarct relationship") may be related to stroke victims' symptom progression.


METHODS
Patients (N = 7) who underwent multiple diffusion-tensor imaging (DTI) studies during symptomatic progression were included in this study. DTI was performed using a single-shot echo-planar imaging (EPI) technique with a motion-probing gradient in six orientations, a b-value of 800 seconds/mm2, and six image averages. The total scan time was four minutes and 24 seconds. Fiber-tracking of the sensorimotor pathways was performed, and the locations of these tracts were retrospectively assessed in relation to the evolution of the symptoms.


RESULTS
Five of the seven patients showed an interval enlargement of the infarct on diffusion-weighted (DW) images. In two of these cases the lesion enlarged to involve the sensorimotor tracts, while in three cases the lesion enlarged only so far to come into close proximity to the sensorimotor tract. In the remaining two cases there was no interval enlargement of the infarct, and therefore the tract-infarct relationship could not account for the evolution of the symptoms in these cases.


CONCLUSIONS
A tract-infarct relationship can be observed with the use of a fiber-tracking technique, and the results may improve our understanding of the symptom progression seen in stroke victims.
Yamada
Kei
K
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto City, Kyoto, Japan. kyamada@koto.kpu-m.ac.jp
Ito
Hirotoshi
H
Nakamura
Hisao
H
Kizu
Osamu
O
Akada
Wataru
W
Kubota
Takao
T
Goto
Mariko
M
Konishi
Jyunya
J
Yoshikawa
Kenji
K
Shiga
Kensuke
K
Nakagawa
Masanori
M
Mori
Susumu
S
Nishimura
Tsunehiko
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000503:physiopathology; D038524:Diffusion Magnetic Resonance Imaging; D018450:Disease Progression; D017352:Echo-Planar Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000473:pathology* / Q000503:physiopathology; D009434:Neural Pathways / Q000473:pathology; D013003:Somatosensory Cortex / Q000473:pathology* / Q000503:physiopathology