title: Preoperative Visualization of Cranial Nerves in Skull Base Tumor Surgery Using Diffusion Tensor Imaging Technology.
abstract: OBJECTIVE
  To visualize cranial nerves (CNs) using diffusion tensor imaging (DTI) with special parameters. This study also involved the evaluation of preoperative estimates and intraoperative confirmation of the relationship between nerves and tumor by verifying the accuracy of visualization.
  
  
  METHODS
  3T magnetic resonance imaging scans including 3D-FSPGR, FIESTA, and DTI were used to collect information from 18 patients with skull base tumor. DTI data were integrated into the 3D slicer for fiber tracking and overlapped anatomic images to determine course of nerves. 3D reconstruction of tumors was achieved to perform neighboring, encasing, and invading relationship between lesion and nerves.
  
  
  RESULTS
  Optic pathway including the optic chiasm could be traced in cases of tuberculum sellae meningioma and hypophysoma (pituitary tumor). The oculomotor nerve, from the interpeduncular fossa out of the brain stem to supraorbital fissure, was clearly visible in parasellar meningioma cases. Meanwhile, cisternal parts of trigeminal nerve and abducens nerve, facial nerve were also imaged well in vestibular schwannomas and petroclival meningioma cases. The 3D-spatial relationship between CNs and skull base tumor estimated preoperatively by tumor modeling and tractography corresponded to the results determined during surgery.
  
  
  CONCLUSIONS
  Supported by DTI and 3D slicer, preoperative 3D reconstruction of most CNs related to skull base tumor is feasible in pathological circumstances. We consider DTI Technology to be a useful tool for predicting the course and location of most CNs, and syntopy between them and skull base tumor.
authors.affiliation: General Hospital of Tianjin Medical University, Division of Neurosurgery, Tianjin, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Ma
authors.forename: Shaobo
authors.initials: S
authors.lastname: Su
authors.forename: Shuyuan
authors.initials: S
authors.lastname: Yue
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhao
authors.forename: Yonggang
authors.initials: Y
authors.lastname: Li
authors.forename: Xiaochen
authors.initials: X
authors.lastname: Chen
authors.forename: Hui
authors.initials: H
authors.lastname: Ma
mesh_terms: D000328:Adult; D003391:Cranial Nerves / Q000000981:diagnostic imaging*; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D011300:Preoperative Care / Q000379:methods*; D019292:Skull Base Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery