title: Utilization of diffusion tensor tractography in combination with spatial normalization to assess involvement of the corticospinal tract in capsular/pericapsular stroke: Feasibility and clinical implications.
abstract: OBJECTIVE
  To investigate the feasibility of using spatial normalization in combination with diffusion tensor (DT) corticospinal tractography to assess corticospinal tract (CST) involvement in capsular or pericapsular stroke.
  
  
  METHODS
  Corticospinal tractograms were created and segmented out using DT imaging (DTI) data from 10 normal volunteers. After spatial normalization was achieved with statistical parametric mapping (SPM), the whole ensemble of tractograms was used as a map of the CST. This was overlaid on the infarction site, which had also been spatially normalized from isotropic diffusion-weighted (DW) images of 14 patients with small symptomatic capsular or pericapsular infarction. We evaluated the extent of CST involvement within the infarction site. Differences were sought in relation to recovery of muscle strength.
  
  
  RESULTS
  The CST was engulfed by the infarction in all patients. Muscle strength recovery occurred in 10 of the 14 patients. The extent of cross-sectional and longitudinal involvement in the infarction site was related to motor recovery (P = 0.041).
  
  
  CONCLUSIONS
  An evaluation of the involvement of the CST in cases of capsular or pericapsular infarction utilizing DT fiber tractography in combination with spatial normalization was found to be feasible as it clearly visualized the extent of CST involvement consistent with the symptom.
authors.affiliation: Department of Radiology, University of Tsukuba, Tsukuba, Japan. akrk-tky@umin.ac.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Kunimatsu
authors.forename: Daisuke
authors.initials: D
authors.lastname: Itoh
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Nakata
authors.forename: Natsuko
authors.initials: N
authors.lastname: Kunimatsu
authors.forename: Shigeki
authors.initials: S
authors.lastname: Aoki
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Masutani
authors.forename: Osamu
authors.initials: O
authors.lastname: Abe
authors.forename: Mariko
authors.initials: M
authors.lastname: Yoshida
authors.forename: Manabu
authors.initials: M
authors.lastname: Minami
authors.forename: Kuni
authors.initials: K
authors.lastname: Ohtomo
mesh_terms: D000368:Aged; D001931:Brain Mapping / Q000379:methods; D038524:Diffusion Magnetic Resonance Imaging; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016018:Least-Squares Analysis; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000473:pathology; D011712:Pyramidal Tracts / Q000473:pathology* / Q000503:physiopathology; D020127:Recovery of Function; D020521:Stroke / Q000473:pathology* / Q000503:physiopathology