title: Diffusional kurtosis imaging in evaluating the secondary change of corticospinal tract after unilateral cerebral infarction.
abstract: We investigated to evaluate whether diffusional kurtosis imaging (DKI) can early detect the microstructure change of corticospinal tract (CST) after unilateral cerebral infarction solely in middle cerebral artery (MCA) territory. Seventy-seven patients with MCA territory infarct consisting of 10 subjects of hyperacute phase, 22 subjects of acute phase, 28 subjects of subacute phase and 17 subjects of chronic phase were enrolled in this study. ROI method was performed to measure the mean value of the infarcted area and the areas which belongs to CST [including the posterior limb of internal capsule (PLIC), cerebral peduncle (CP), pons, and medulla] in both ipsilateral and contralateral mirror side in all the DKI-derived parametric maps. Compared with the contralateral mirror side, MK, K║, K┴in the infarcted area sharply increased to a peak in acute phase, and then gradually fell down. MD, D║and D┴decreased till acute phase and then started to increase gradually. FA decreased more and more seriously from hyperacute to chronic phase. K║and D║were more helpful to detect the subtle changes of CST after infarction as they both had significant changes in all phases. Moreover, there were more locations that had significant changes with time going on. To conclude, DKI, especially the variable K║and D║, may serve as a new biomarker to observe the microstructure change of the descending CST, which may reflect the extent of Wallerian degeneration and be helpful for clinical decision making.
authors.affiliation: Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan, China.
authors.forename: Shun
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan, China.
authors.forename: Wenjie
authors.initials: W
authors.lastname: Zhu
authors.affiliation: Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan, China.
authors.forename: Yihao
authors.initials: Y
authors.lastname: Yao
authors.affiliation: Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan, China.
authors.forename: Jingjing
authors.initials: J
authors.lastname: Shi
authors.affiliation: The Center for Biomedical Research, Key Laboratory of Organ Transplantation, Ministry of Health & Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan, China.
authors.forename: Cong-Yi
authors.initials: CY
authors.lastname: Wang
authors.affiliation: Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan, China.
authors.forename: Wenzhen
authors.initials: W
authors.lastname: Zhu
keywords: Diffusional kurtosis imaging; Wallerian degeneration; corticospinal tract; middle cerebral artery occlusion