title: Diffusion tensor imaging--arcuate fasciculus and the importance for the neurosurgeon.
abstract: OBJECTIVE
  Tumors in eloquent areas of the brain like Broca or Wernicke might have disastrous consequences for patients. We intended to visualize the arcuate fasciculus (AF) and to demonstrate his relation with the corticospinal tract and the visual pathway using diffusion tensor imaging (DTI).
  
  
  METHODS
  We depicted between 2012 and 2014 the AF in 71 patients. Men and women of all ages were included. Eleven patients had postoperative controls also. We used a 3DT1-sequence for the navigation. Furthermore T2- and DTI-sequences were performed. The FOV was 200 × 200 mm(2), slice thickness 2mm, and an acquisition matrix of 96 × 96 yielding nearly isotropic voxels of 2 × 2 × 2 mm. 3-Tesla-MRI was carried out strictly axial using 32 gradient directions and one b0-image. We used Echo-Planar-Imaging (EPI) and ASSET parallel imaging with an acceleration factor of 2. b-Value was 800 s/mm(2). Additional scanning time was less than 9 min.
  
  
  RESULTS
  AF was portrayed in 63 patients bilaterally. In one glioblastoma patient it was impossible to visualize the left AF and in seven other patients we could not portray the right one. The lesions affected AF by disrupting or displacing the fibers.
  
  
  CONCLUSIONS
  DTI might be a useful tool to portray AF. It is time-saving and can be used to preserve morbidity in patients with lesions in eloquent brain areas. It might give deeper insights of the white matter and the reorganization of AF-fibers postoperatively.
authors: Centre Hospitalier de Luxembourg, Neurosurgery, Luxembourg, Luxembourg. Electronic address: ahana2410@gmail.com.
authors: Ardian
authors: A
authors: Hana
authors: Centre Hospitalier de Luxembourg, Neurosurgery, Luxembourg, Luxembourg. Electronic address: dooms.georges@chl.lu.
authors: Georges
authors: G
authors: Dooms
authors: Centre Hospitalier de Luxembourg, Neurosurgery, Luxembourg, Luxembourg. Electronic address: boecher-schwarz.hans@chl.lu.
authors: Hans
authors: H
authors: Boecher-Schwarz
authors: Centre Hospitalier de Luxembourg, Neurosurgery, Luxembourg, Luxembourg. Electronic address: hertel.frank@chl.lu.
authors: Frank
authors: F
authors: Hertel
mesh_terms: D001037:Aphasia / Q000209:etiology; D001111:Arcuate Nucleus of Hypothalamus / Q000473:pathology* / Q000601:surgery*; D001932:Brain Neoplasms / Q000473:pathology / Q000601:surgery; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007029:Hypothalamic Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D000069471:Neurosurgeons; D019635:Neurosurgical Procedures / Q000379:methods*; D011712:Pyramidal Tracts / Q000473:pathology / Q000601:surgery; D012307:Risk Factors; D016896:Treatment Outcome; D014795:Visual Pathways / Q000473:pathology / Q000601:surgery
keywords: Arcuate fasciculus; Cerebral lesions; Diffusion tensor imaging