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Tumor Effects on Cerebral White Matter as Characterized by Diffusion Tensor Tractography

Published online by Cambridge University Press:  02 December 2014

Corie W. Wei ,
Gang Guo  and
David J. Mikulis
Corie W. Wei
Affiliation:
Schulich School of Medicine and Dentistry, University of Western, Ontario, London, ON
Gang Guo
Affiliation:
Department of Radiology, Shantou University, Shantou, China
David J. Mikulis
Affiliation:
Department of Medical Imaging, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada
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Abstract

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Background:

Diffusion tensor MRI fiber tractography (DTT) is the first non-invasive in vivo technique for delineating specific white matter (WM) tracts. In cerebral neoplasm, DTT can be used to illustrate the relationship of the tumor with respect to adjacent WM trajectories.

Methods:

Fiber tractography was used in this study to assess tumor-induced changes in WM trajectories in three cases of cerebral neoplasm: glioblastoma multiforme, meningioma, and anaplastic astrocytoma.

Results:

Three patterns of WM alteration were identified: 1) disruption, 2) displacement, and 3) infiltration. Tumor disruption of WM tracts was observed in glioblastoma multiforme, which terminated fibers crossing the corpus callosum. In meningioma, DTT illustrated bulk displacement of the corticospinal tract in the affected hemisphere as well as preservation of the deviated axons. In anaplastic astrocytoma, fiber tracking demonstrated disruption of WM tracts at the tumor origin as well as intact axons through areas of tumor infiltration.

Conclusions:

Fiber tracking results correlated with the clinical and histopathological features of the tumor. Larger case series will be required to determine if fiber tracking can add accuracy to existing imaging methods for grading tumors.

Résumé:

RÉSUMÉ: Contexte:

La tractographie par IRM en tenseur de diffusion (TTD) pour étudier les fibres de la substance blanche (SB) est la première technique non effractive in vivo permettant de localiser des faisceaux spécifiques. Dans les tumeurs cérébrales, la TTD peut être utilisée pour illustrer la relation entre la tumeur et la trajectoire des faisceaux de la SB adjacents à la tumeur.

Méthodes:

La tractographie de faisceaux de fibres a été utilisée dans cette étude pour évaluer les changements induits par la tumeur dans la trajectoire de faisceaux de la SB chez trois cas de néoplasie cérébrale : un glioblastome multiforme, un méningiome et un astrocytome anaplasique.

Résultats:

Trois types de changements ont été identifiés dans la SB : 1) interruption; 2) déplacement et 3) infiltration. L' interruption de faisceaux de la SB à travers le corps calleux a été observée dans le glioblastome multiforme. Dans le méningiome, la TTD a montré un déplacement en masse du faisceau corticospinal dans l'hémisphère touché ainsi que la préservation des axones déplacés. Dans l'astrocytome anaplasique, la tractographie a montré une interruption des faisceaux de la SB là oùtumeur avait pris naissance ainsi que des axones intacts dans les zones d'infiltration de la tumeur.

Conclusions:

Les résultats de la tractographie concordaient avec les manifestations cliniques et histopathologiques de la tumeur. Il faudra étudier un plus grand nombre de cas pour déterminer si la tractographie de fibres peut améliorer la précision des méthodes d'imagerie actuelles pour évaluer le grade d'une tumeur.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 34 , Issue 1 , February 2007 , pp. 62 - 68
Copyright
Copyright © The Canadian Journal of Neurological 2007

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