Corticospinal tract localization: integration of diffusion-tensor tractography at 3-T MR imaging with intraoperative white matter stimulation mapping--preliminary results.
Institutional review board approval and written informed consent were obtained. The purpose of this study was to prospectively validate usefulness of diffusion-tensor (DT) fiber tractography of the corticospinal tract at 3-T magnetic resonance imaging, in combination with the subcortical motor-evoked potential (MEP) technique, as a tool for tractography-guided neurosurgery. DT imaging and corticospinal tractography were performed at 3 T in eight patients (four men, four women; mean age, 41 years; age range, 23-58 years) with intracranial space-occupying lesions. Tractography data were transferred to a neuronavigation system, and tractography-guided neurosurgery was performed. During lesion resection, subcortical MEPs were recorded. Positive MEP response was observed in four patients. No patients developed new motor weakness postoperatively. Complementary use of tractography and MEP may be useful for intraoperative depiction of corticospinal tracts.
Okada
Tsutomu
T
Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
Mikuni
Nobuhiro
N
Miki
Yukio
Y
Kikuta
Ken-Ichiro
K
Urayama
Shin-Ichi
S
Hanakawa
Takashi
T
Fushimi
Yasutaka
Y
Yamamoto
Akira
A
Kanagaki
Mitsunori
M
Fukuyama
Hidenao
H
Hashimoto
Nobuo
N
Togashi
Kaori
K
D000328:Adult; D001931:Brain Mapping / Q000379:methods*; D019054:Evoked Potentials, Motor; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011712:Pyramidal Tracts / Q000033:anatomy & histology*