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65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

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Quantification of corticospinal tracts in brainstem surgery: Initial experiences with diffusion tensor imaging at 3-T-MRI

Meeting Abstract

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  • Nils H. Ulrich - Department of Neuroradiology, University Hospital, University of Zurich, Switzerland; Department of Neurosurgery, University Hospital, University of Zurich, Switzerland
  • Yuqiang Yao - Department of Neuroradiology, University Hospital, University of Zurich, Switzerland
  • Uzeyir Ahmadli - Department of Neuroradiology, University Hospital, University of Zurich, Switzerland
  • Christoph M. Woernle - Department of Neurosurgery, University Hospital, University of Zurich, Switzerland
  • Roman Guggenberger - Department of Neuroradiology, University Hospital, University of Zurich, Switzerland
  • Helmut Bertalanffy - International Neuroscience Institute (INI), Hannover, Germany
  • Spyros S. Kollias - Department of Neuroradiology, University Hospital, University of Zurich, Switzerland

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocMO.16.04

doi: 10.3205/14dgnc092, urn:nbn:de:0183-14dgnc0925

Published: May 13, 2014

© 2014 Ulrich et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective: Because of the complex and dense anatomy of the brainstem, visualization of brainstem lesions remains challenging for neuroradiologists and neurosurgeons. The purpose of our study is to investigate the utility of diffusion tensor imaging (DTI) to map and quantify the corticospinal tracts (CSTs) in patients with brainstem lesions in regard to predict clinical outcome.

Method: Fourteen consecutive patients were retrospectively analyzed. DTI was used to determine the fractional anisotropy (FA), the apparent diffusion coefficient (ADC) of the CST. The CSTs were quantified during the pre- and postoperative course and correlated to the clinical course of each patient.

Results: Correlations between FA and ADC of the CST and the corresponding clinical status were found. Furthermore, in most cases DTI-tracking allowed a broad illustration of the CST and we distinctly demonstrated pre- and postoperative variations during the clinical course.

Conclusions: Our study confirms that quantification of CSTs with DTI is a promising tool and helps to explain associated neurological findings and may predict outcome. Furthermore, visualizing the tracts improves our understanding of the tilted brainstem anatomy when planning those cases for surgical Intervention.