title: Corticospinal tract localization: integration of diffusion-tensor tractography at 3-T MR imaging with intraoperative white matter stimulation mapping--preliminary results.
abstract: 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.
authors.affiliation: Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Okada
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Mikuni
authors.forename: Yukio
authors.initials: Y
authors.lastname: Miki
authors.forename: Ken-Ichiro
authors.initials: K
authors.lastname: Kikuta
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Urayama
authors.forename: Takashi
authors.initials: T
authors.lastname: Hanakawa
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Fushimi
authors.forename: Akira
authors.initials: A
authors.lastname: Yamamoto
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Kanagaki
authors.forename: Hidenao
authors.initials: H
authors.lastname: Fukuyama
authors.forename: Nobuo
authors.initials: N
authors.lastname: Hashimoto
authors.forename: Kaori
authors.initials: K
authors.lastname: Togashi
mesh_terms: 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*