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- Dokumenttyp:
- Journal Article
- Autor(en):
- Liang, Raimunde; Schwendner, Maximilian; Grziwotz, Marc; Wiestler, Benedikt; Wostrack, Maria; Meyer, Bernhard; Krieg, Sandro M; Ille, Sebastian
- Titel:
- Improving tractography in brainstem cavernoma patients by distortion correction.
- Abstract:
- INTRODUCTION: The resection of brainstem cerebral cavernous malformations (CCM) harbors the risk of damaging the corticospinal tract (CST) and other major tracts. Hence, visualization of eloquent fiber tracts supports pre- and intraoperative planning. However, diffusion tensor imaging fiber tracking at brainstem level suffers from distortion due to field inhomogeneities and eddy currents by steep diffusion gradients. RESEARCH QUESTION: This study aims to analyze the effect of distortion correction for CST tractography in brainstem CCM patients. MATERIAL AND METHODS: 25 patients who underwent resection of brainstem CCM were enrolled, 24 suffered from hemorrhage. We performed an anatomically based tractography of the CST with a mean minimal fractional anisotropy of 0.22 ± 0.04 before and after cranial distortion correction (CDC). Accuracy was measured by anatomical plausibility and aberrant fibers. RESULTS: CDC led to a more precise CST tractography, further approximating its assumed anatomical localization in all cases. CDC resulted in a significantly more ventral location of the CST of 1.5 ± 0.6 mm (6.1 ± 2.7 mm before CDC vs. 4.6 ± 2.1 mm after CDC; p < .0001) as measured by the distance to the basilar artery and of 1.7 ± 0.6 mm (8.9 ± 2.7 mm vs. 7.2 ± 2.1 mm; p < .0001) in relation to the clivus. Aberrant fibers were reduced by CDC in 44% of cases. We found a mean difference in CST volume of 0.6 ± 0.8 ccm. We could not detect motor deficits after resection of irregular fibers. DISCUSSION AND CONCLUSION: CDC effectively corrects tractography for distortion at brainstem level, especially in patients suffering from brainstem CCM, further approximating its actual anatomical localization.
- Zeitschriftentitel:
- Brain Spine
- Jahr:
- 2023
- Band / Volume:
- 3
- Volltext / DOI:
- doi:10.1016/j.bas.2023.102685
- PubMed:
- http://view.ncbi.nlm.nih.gov/pubmed/38021010
- Print-ISSN:
- 2772-5294
- TUM Einrichtung:
- Klinik und Poliklinik für Neurochirurgie (Prof. Meyer)
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