title: Diffusion tensor imaging and tractography of the corticospinal tract in the presence of enlarged Virchow-Robin spaces.
abstract: OBJECTIVE
  We report a patient with abnormal diffusion tensor imaging (DTI) and tractography of the corticospinal tract caused by mass effect from adjacent enlarged Virchow-Robin spaces.
  
  
  METHODS
  DTI was performed using 25 noncollinear directions. Fractional anisotropy (FA) and mean diffusivity (MD) maps were generated. Region-of-interest measurements of the corticospinal tracts were organized in histograms, and comparisons were made between sides. Statistical analysis consisted of a Wilcoxon rank-sum nonparametric test and a two-sample test of proportions to compare the relative percentage of voxels >.8.
  
  
  RESULTS
  The patient had no signs or symptoms of motor weakness. The corticospinal tract adjacent to the enlarged Virchow-Robin spaces showed significant changes in the proportion of FA > .8, distribution of FA and distribution of MD (P < .001).
  
  
  CONCLUSIONS
  Diffusion tensor changes may be caused by enlarged Virchow-Robin spaces in the absence of clinical signs or symptoms. We hypothesize that the DTI changes are due to alterations in the extravascular extracellular space. Tensor changes should be interpreted with caution in patients with space occupying mass lesions such as brain tumors.
authors.affiliation: Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Young
authors.forename: Valerie
authors.initials: V
authors.lastname: Lee
authors.forename: Kyung K
authors.initials: KK
authors.lastname: Peck
authors.forename: Tania
authors.initials: T
authors.lastname: Sierra
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Zhang
authors.forename: Lindsay M
authors.initials: LM
authors.lastname: Jacks
authors.forename: Andrei I
authors.initials: AI
authors.lastname: Holodny
mesh_terms: D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000473:pathology; D055806:Microvessels / Q000473:pathology*; D008875:Middle Aged; D011712:Pyramidal Tracts / Q000473:pathology*; D013346:Subarachnoid Space / Q000473:pathology*
references.citation: AJNR Am J Neuroradiol. 2007 Sep;28(8):1523-5
references.pmid: 17846204
references.citation: AJNR Am J Neuroradiol. 2004 Mar;25(3):356-69
references.pmid: 15037456
references.citation: AJNR Am J Neuroradiol. 2005 Apr;26(4):791-6
references.pmid: 15814922
references.citation: AJNR Am J Neuroradiol. 2011 Apr;32(4):709-13
references.pmid: 21349956
references.citation: Comput Biomed Res. 1996 Jun;29(3):162-73
references.pmid: 8812068
references.citation: AJNR Am J Neuroradiol. 2010 Jun;31(6):1023-30
references.pmid: 20110374
references.citation: Comput Methods Programs Biomed. 2006 Feb;81(2):106-16
references.pmid: 16413083
references.citation: Ann Neurol. 1999 Feb;45(2):265-9
references.pmid: 9989633
references.citation: J Neurol Sci. 1998 Jul 15;159(1):25-7
references.pmid: 9700699
references.citation: AJNR Am J Neuroradiol. 2004 May;25(5):699-705
references.pmid: 15140707
references.citation: Radiographics. 2007 Jul-Aug;27(4):1071-86
references.pmid: 17620468
references.citation: Stroke. 2010 May;41(5):910-5
references.pmid: 20378864
references.citation: Radiology. 1999 Sep;212(3):770-84
references.pmid: 10478246
references.citation: AJNR Am J Neuroradiol. 2007 Mar;28(3):462-9
references.pmid: 17353313
references.citation: Magn Reson Med. 1996 Feb;35(2):162-7
references.pmid: 8622579