Diffusion tensor tractography predicts motor functional outcome in patients with spontaneous intracerebral hemorrhage.
OBJECTIVE
We prospectively investigated the predictive value of diffusion tensor tractography for motor functional outcome in a case series of patients with intracerebral hemorrhage.


METHODS
Diffusion tensor tractography was performed in 17 patients with intracerebral hemorrhage (putamen, nine patients; thalamus, seven patients; combined, one patient) within 5 days after onset. Mean fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values along the corticospinal tracts at the level of the hematoma were measured bilaterally, and the ratios of values (hematoma side/contralateral side) were determined as FA and ADC ratios, respectively. Patients were evaluated for motor function on admission and at 3 months after onset using the manual muscle test score and then divided into good (manual muscle test, 4-5) and poor (manual muscle test, 0-3) motor function groups.


RESULTS
FA ratio measured shortly after the onset of intracerebral hemorrhage correlated well with motor functional outcome at 3 months (P < 0.05) but not with motor function on admission. FA ratios in the group with good motor functional outcome were significantly higher than those in the group with poor motor functional outcome (P < 0.01). The ADC ratio did not correlate with motor function either on admission or at 3 months. All patients with an FA ratio greater than 0.8 had a good motor functional outcome. In three patients, however, motor functional outcomes were favorable even though FA ratios were not high; in these patients, ADC ratios tended to be elevated.


CONCLUSIONS
Motor functional outcome in patients with intracerebral hemorrhage can be predicted by measuring FA values using diffusion tensor tractography.
Yoshioka
Hideyuki
H
Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Yamanashi, Japan. hidey@yamanashi.ac.jp
Horikoshi
Toru
T
Aoki
Shigeki
S
Hori
Masaaki
M
Ishigame
Keiichi
K
Uchida
Mikito
M
Sugita
Masao
M
Araki
Tsutomu
T
Kinouchi
Hiroyuki
H
D000368:Aged; D016880:Anisotropy; D002543:Cerebral Hemorrhage / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006225:Hand / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D018482:Muscle, Skeletal / Q000503:physiopathology; D011446:Prospective Studies; D011597:Psychomotor Performance; D011712:Pyramidal Tracts / Q000473:pathology; D020127:Recovery of Function; D018709:Statistics, Nonparametric