gms | German Medical Science

66th Annual Meeting of the German Society of Neurosurgery (DGNC)
Friendship Meeting with the Italian Society of Neurosurgery (SINch)

German Society of Neurosurgery (DGNC)

7 - 10 June 2015, Karlsruhe

Article

Send article

Diffusion tensor imaging and intraoperative motor evoked potentials in brainstem surgery: Linkage between function and structure

Meeting Abstract

Search Medline for

  • Nils H. Ulrich - Department of Neuroradiology, University Hospital, University of Zurich, Switzerland
  • Yuqiang Yao - Department of Neuroradiology, University Hospital, University of Zurich, Switzerland; Department of Neurosurgery, Beijing Jishuitan Hospital, China
  • Helmut Bertalanffy - International Neuroscience Institute, INI, Hannover, Germany
  • Johannes Sarnthein - Department of Neurosurgery, University Hospital, University of Zurich, Switzerland
  • Spyros S. Kollias - Department of Neuroradiology, University Hospital, University of Zurich, Switzerland

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocMI.17.03

doi: 10.3205/15dgnc380, urn:nbn:de:0183-15dgnc3806

Published: June 2, 2015

© 2015 Ulrich et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Surgical resection, spatial imaging and intraoperative monitoring of brainstem lesions remain a major challenge for neurosurgeons and clinical neuroscientist. Concerning the brainstem, imaging with Diffusion Tensor imaging (DTI) and intraoperative motor evoked potentials (ioMEPs) are demanding to apply. We hypothesize that quantitative data of DTI and ioMEPs could shed light on the linkage between function and structure in brainstem lesions.

Method: DTI and ioMEPs data were analyzed in 14 patients with brainstem lesions. We quantified DTI using fractional anisotropy (FA) and apparent diffusion coefficient (ADC) in regions of interest. In addition we applied ioMEPs (amplitude and velocity) to determine alterations of the CSTs.

Results: Quantification of DTI showed alterations during the pre- and postoperative course. Accordingly, associations between infiltrated CSTs and ioMEPS were demonstrated in certain patients. Reestablishment of the morphological changes in the affected CST postoperatively was associated with a trend for decreasing ADC compared to the pre-operative measurements.

Conclusions: This study forms an excellent foundation for future investigations to evaluate the compatibility of DTI and ioMEPs in brainstem lesion. Our application of DTI and ioMEPs acknowledges the linkage between function and physiology. The distribution of DTI changes and variations in ioMEPs helps neurosurgeons and neurophysiologist to better understand the involvement of the intrinsic brainstem anatomy by pathological processes.