title: Early experience with 3-T magnetic resonance tractography in the surgery of cerebral arteriovenous malformations in and around the visual pathway.
abstract: OBJECTIVE
  To evaluate of the role of magnetic resonance (MR) tractography on the optic radiation with a 3-T MR unit in the surgery of cerebral arteriovenous malformation (AVM) in and around the visual pathway.
  
  
  METHODS
  Of the 322 patients with cerebral AVMs admitted to our clinic between 1978 and 2005, a study of MR tractography was made on 29 patients. Ten of those patients had AVMs in and around the visual pathway and were included in this study. There were two men and eight women ranging in age from 15 to 64 years (mean age, 34.5 +/- 14.8 yr). All of the patients underwent 3-T tractography of optic radiation (OR) and neuro-ophthalmologic evaluation. Four of the 10 patients underwent surgical resection of the AVM. A postoperative 3-T MR study and a neuro-ophthalmologic evaluation was performed 1 month after surgery in most patients.
  
  
  RESULTS
  The preoperative patients for whom tractography demonstrated a continuous bundle of OR from the medial temporal region to the primary visual cortex had minimal or no visual field loss, whereas the patients for whom the tractography did not show a continuous bundle of OR had significant visual loss. The patients for whom tractography in the postoperative study demonstrated a bundle of OR experienced no postoperative deterioration of the visual field loss, whereas the patients for whom tractography did not demonstrate a bundle of OR exhibited significant visual field loss.
  
  
  CONCLUSIONS
  This technique is thought to be useful in confirming the integrity of and localizing deviated tract and in evaluating the surgical risk, especially for nonhemorrhagic AVMs in and around the visual pathways, taking some limitations of this method into consideration.
authors.affiliation: Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan. kikuta@kuhp.kyoto-u.ac.jp
authors.forename: Ken-ichiro
authors.initials: K
authors.lastname: Kikuta
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Takagi
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nozaki
authors.forename: Takashi
authors.initials: T
authors.lastname: Hanakawa
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Okada
authors.forename: Yukio
authors.initials: Y
authors.lastname: Miki
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Fushimi
authors.forename: Hidenao
authors.initials: H
authors.lastname: Fukuyama
authors.forename: Nobuo
authors.initials: N
authors.lastname: Hashimoto
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging* / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D011859:Radiography; D014795:Visual Pathways / Q000002:abnormalities / Q000000981:diagnostic imaging* / Q000601:surgery*