Flexible ex vivo phantoms for validation of diffusion tensor tractography on a clinical scanner

Purpose The aim of this study was to develop ex vivo diffusion tensor (DT) flexible phantoms. Materials and methods Materials were bundles of textile threads of cotton, monofilament nylon, rayon, and polyester bunched with spiral wrapping bands and immersed in water. DT images were acquired on a 1.5-Tesla clinical magnetic resonance scanner using echo planar imaging sequences with 15 motion probing gradient directions. DT tractography with seeding and a line-tracking method was carried out by software originally developed on a PC-based workstation. Results We observed relatively high fractional anisotropy on the polyester phantom and were able to reconstruct tractography. Straight tracts along the bundle were displayed when it was arranged linearly. It was easy to bend arcuately or bifurcate at one end; and tracts followed the course of the bundle, whether it was curved or branched and had good agreement with direct visual observation. Tractography with the other fibers was unsuccessful. Conclusion The polyester phantom revealed a diffusion anisotropic structure according to its shape and would be utilizable repeatedly under the same conditions, differently from living central neuronal system. It would be useful to validate DT sequences and to optimize an algorithm or parameters of DT tractography software. Additionally, the flexibility of the phantom would enable us to model human axonal projections.     

Motor control via spared peri-infarct corticospinal tract in patients with pontine infarct

We investigated the motor control pathway in 3 patients with pontine infarct using diffusion tensor tractography and functional magnetic resonance imaging. The motor tracts of the affected hemisphere were observed to pass along the same spared peri-infarct corticospinal tract area of the pons on both the first and second diffusion tensor tractography. It seems that the main motor function of these patients is controlled via the spared peri-infarct corticospinal tract.     

脑高级别星形细胞瘤瘤周DTI参数的测定及分析

目的：应用弥散张量成像（DTI）技术探讨脑高级别星形细胞瘤瘤周弥散各向异性特点。方法：25例脑高级别星形细胞瘤术前行DTI扫描,测定瘤周脑实质区及对侧正常脑实质的平均弥散系数（MD）值及各向异性分数（FA）值。并通过弥散张量纤维束成像（DTT）观察病灶与白质纤维束的关系。结果：高级别星形细胞瘤瘤周MD值为1．610±0．23,高于对侧正常脑实质（P〈0．01）。FA值为0．236±0．06,低于对侧正常脑实质（P〈0．01）。结论：DTI能够准确反应脑星形细胞瘤瘤周各向异性特点,DTT能够较为准确显示病灶与白质纤维束的关系。     

Diffusion tensor tractography of gliomatosis cerebri: fiber tracking through the tumor

In previous reports, tracts obtained by diffusion tensor (DT) fiber tracking were terminated or deviated by the brain tumors or surrounding edema. There has been no report showing diffusion tensor tractography penetrating through the tumor. A case of glioma is reported, whose DT fiber tract passing through the tumor was observed by changing the threshold of fractional anisotropy.     

Diffusion anisotropy and diffusivity of white matter tracts within the temporal stem in Alzheimer disease: evaluation of the "tract of interest" by diffusion tensor tractography

PURPOSE: Our aim was to determine whether diffusion anisotropy and diffusivity of white matter tracts of the temporal stem in patients with Alzheimer (AD) can be evaluated independently by using diffusion tensor tractography. MATERIALS AND METHODS: Subjects included 15 patients with AD (11 women and 4 men; mean age, 74 years) and 15 age-matched control subjects (11 women and 4 men; mean age, 72 years). Diffusion tensor images were acquired by using echo-planar imaging. We drew tractographies of the uncinate fasciculus, inferior occipitofrontal fasciculus, and Meyer's loop, with diffusion tensor analysis software. We measured diffusion anisotropy, diffusivity, and the number of voxels along the "tracts of interest" and used the Student t test to compare results between patients with AD and controls. RESULTS: Values of diffusion anisotropy of the bilateral uncinate fasciculus and left inferior occipitofrontal fasciculus were significantly lower for patients with AD than for controls. Also, values of diffusivity in the bilateral uncinate fasciculus were significantly greater for patients with AD than for controls. There was no significant difference in diffusion anisotropy or diffusivity along Meyer's loop between the 2 groups. There was no significant difference in the number of voxels included in all constructed tracts between patients with AD and controls. CONCLUSION: White matter tracts of the temporal stem can be evaluated independently by using diffusion tensor tractography, which appears to be a promising technique for determining changes in white matter in degenerative diseases.     

In vivo visualization of white matter fiber tracts of preterm- and term-infant brains with diffusion tensor magnetic resonance imaging

OBJECTIVE: The goal of this study was to test the feasibility of visualizing a 3-dimensional structure of cerebral white matter fiber tracts in preterm infants, postconceptional age (PCA) 28 weeks to term, by using volumetric diffusion tensor magnetic resonance imaging (DTI) data. MATERIALS AND METHOD: We combined tractography algorithms and visualization methods, currently available for adult DTI data, to trace the pixelated principal direction of a diffusion tensor originating from regions-of-interest with high fractional anisotropy. Consequently, white matter fiber bundles from the genu and the splenium of corpus callosum, the corticospinal tracts, the inferior fronto-occipital fasciculi, and optic radiations were visualized. RESULTS: Our results suggest that major white matter tracts of preterm infant brains, with PCAs ranging from 28 weeks to term (40 weeks old), can be successfully visualized despite the small brain volume and low anisotropy. CONCLUSION: The feasibility of fiber tractography in preterm neonates with DTI may add a new dimension in detection and characterization of white matter injuries of preterm infants.     

Diffusion tensor tractography demonstration of partially injured spinal cord tracts in a patient with posttraumatic Brown Sequard syndrome

The authors report the utility of diffusion tensor tractography in demonstrating the partially severed spinal cord tracts on one side with normal, intact, distally traceable tracts on the opposite side in a patient with posttraumatic Brown Sequard syndrome. A 30-year-old man presented with typical clinical features of a hemisection injury of the thoracic spinal cord, 2 months after he had sustained a back stab injury. Routine MRI showed T2 hyperintense zones in the thoracic spinal cord at the level of T5. We did axial single shot echo planar diffusion tensor imaging with a 1.5 Tesla MR machine. Tractography effectively depicted the injured spinal cord tracts on the left side with normal intact tracts on the right side, which could be traced distally. The fractional anisotropy and apparent diffusion coefficient values showed significant changes at the level of injury. Tractographic demonstration of human spinal cord injury is reported for the first time.     

A method for clustering white matter fiber tracts

BACKGROUND/PURPOSE: Despite its potential for visualizing white matter fiber tracts in vivo, diffusion tensor tractography has found only limited applications in clinical research in which specific anatomic connections between distant regions need to be evaluated. We introduce a robust method for fiber clustering that guides the separation of anatomically distinct fiber tracts and enables further estimation of anatomic connectivity between distant brain regions. METHODS: Line scanning diffusion tensor images (LSDTI) were acquired on a 1.5T magnet. Regions of interest for several anatomically distinct fiber tracts were manually drawn; then, white matter tractography was performed by using the Runge-Kutta method to interpolate paths (fiber traces) following the major directions of diffusion, in which traces were seeded only within the defined regions of interest. Next, a fully automatic procedure was applied to fiber traces, grouping them according to a pairwise similarity function that takes into account the shapes of the fibers and their spatial locations. RESULTS: We demonstrated the ability of the clustering algorithm to separate several fiber tracts which are otherwise difficult to define (left and right fornix, uncinate fasciculus and inferior occipitofrontal fasciculus, and corpus callosum fibers). CONCLUSION: This method successfully delineates fiber tracts that can be further analyzed for clinical research purposes. Hypotheses regarding specific fiber connections and their abnormalities in various neuropsychiatric disorders can now be tested.     

扩散张量的三维纤维束成像在多发性硬化中的应用

目的 应用三维纤维束成像技术,研究多发性硬化(multiple sclerosis,MS)脱髓鞘斑块引起的白质纤维束的改变. 资料与方法 应用3 T 磁共振对34例MS患者和25名非MS健康志愿者行常规头颅MRI和扩散张量成像(DTI),观察MS病灶处和正常表现脑白质的纤维束变化. 结果 三维纤维束成像可以清楚显示脑内白质纤维束的方向、形态和结构.在MS斑块处可见纤维束中断、病灶远端纤维束缺失或稀少.病灶周围的纤维束表现为受压、推移改变.与相同年龄段的正常人对照,MS患者的正常表现胼胝体内纤维束稀少. 结论 基于DTI技术的纤维束成像能够直观地显示脑内白质纤维束,反映病变对纤维造成的影响.     

Diffusion tractography of the cervical spinal cord by using parallel imaging

We applied a single-shot echo-planar axial diffusion tensor sequence with parallel imaging for tractography of the cervical cord. Placing a large region of interest on a reconstructed sagittal image, the cervical cord was depicted as a tract bundle showing color-encoded cephalocaudally. By setting one region of interest in the cerebral peduncle and another in the entire cord on source images, tracts on each side were visualized. This method is promising for tractography of the cervical cord.     

Diffusion tensor MR imaging tractography of the pyramidal tracts correlates with clinical motor function in children with congenital hemiparesis

BACKGROUND AND PURPOSE: Children with congenital hemiparesis have greater asymmetry in diffusion parameters of the pyramidal tracts compared with control subjects. We hypothesized that the asymmetry correlates with the severity of hemiparesis and that diffusion metrics would be abnormal in the affected tracts and normal in the unaffected tracts. MATERIALS AND METHODS: Fifteen patients with congenital hemiparesis and 17 age-matched control subjects were studied with diffusion tensor MR imaging tractography. Hemipareses were scored as mild, moderate, or severe. We measured tract-specific diffusion parameters (fractional anisotropy, mean, and directional diffusion coefficients) of the pyramidal tracts. We compared tract-specific parameters and asymmetry between the right and left tracts of the differing severity groups and control subjects. RESULTS: We observed many different causes of congenital hemiparesis including venous infarction, arterial infarction, and polymicrogyria. Clinical severity of hemiparesis correlated with asymmetry in fractional anisotropy (P < .0001), transverse diffusivity (P < .0001), and mean diffusivity (P < .03). With increasing severity of hemiparesis, fractional anisotropy decreased (P < .0001) and transverse diffusivity (P < .0001) and mean diffusivity (P < .02) increased in the affected pyramidal tract compared with controls. Diffusion metrics in the unaffected tract were similar to those in the control subjects. CONCLUSION: Asymmetry in fractional anisotropy, transverse diffusivity, and mean diffusivity, as well as the degree of abnormality in the actual values of the affected pyramidal tracts themselves, correlates with the severity of motor dysfunction in infants and children with congenital hemiparesis from different causes. This suggests that abnormalities detected by diffusion tensor MR imaging tractography in the affected pyramidal tract are related to the functional ability of the affected pyramidal tract, regardless of the etiology of motor dysfunction.     

DTI-based three-dimensional tractography detects differences in the pyramidal tracts of infants and children with congenital hemiparesis

PURPOSE: To test the hypothesis that there is greater asymmetry in diffusion properties between right and left pyramidal tracts in patients with congenital hemiparesis than in patients with normal motor function. MATERIALS AND METHODS: Four congenitally hemiparetic patients and four age-matched controls underwent magnetic resonance diffusion tensor imaging (DTI)-based three-dimensional tractography of the pyramidal tracts. Relative anisotropy, individual eigenvalues, and directionally averaged apparent diffusion coefficient were measured and degree of asymmetry was calculated. RESULTS: Compared with age-matched controls, congenitally hemiparetic patients had greater asymmetry in all measured diffusion properties. The asymmetry was characterized primarily by lower anisotropy, lower parallel diffusion, higher transverse diffusion, and slightly higher mean diffusivity in the pyramidal tract contralateral to the hemiparesis (i.e., affected pyramidal tract) compared with the unaffected pyramidal tract. CONCLUSIONS: There appears to be greater diffusion asymmetry between the pyramidal tracts in congenitally hemiparetic patients compared to controls. These differences suggest that there are alterations in the microstructure of the pyramidal tract that controls the motor function of the hemiparetic side. Our results suggest that DTI-based three-dimensional tractography is potentially useful in the assessment of motor dysfunction in infants and children with congenital hemiparesis.     

Displacement of the facial nerve course by vestibular schwannoma: preoperative visualization using diffusion tensor tractography

PURPOSE: To preoperatively visualize the course of the facial nerve, which is displaced by vestibular schwannoma, using diffusion tensor (DT) tractography, and to evaluate the agreement with surgical findings. MATERIALS AND METHODS: The subjects were eight patients with vestibular schwannoma who had undergone removal surgery. DT MR images were obtained and tracts that were considered to represent the facial nerve were constructed. We assessed the success rate for tract construction and evaluated the agreement between tractography findings and surgery. RESULTS: We obtained a tract that connected the internal auditory meatus and brainstem, and was considered to represent the facial nerve in seven of eight cases. The course of the constructed tract agreed with surgical findings in five of these seven cases. One exception was a case in which the tumor was too large to enable intraoperative observation of the facial nerve; however, the facial nerve appeared to be displaced anteriorly at intracapsular resection, in agreement with tractography. In the other case, the schwannoma was mostly cystic. CONCLUSION: Tractographs constructed using MR tensor images enabled us to identify tracts considered to represent facial nerves. We consider DT tractography to be a useful tool for preoperatively predicting facial nerve displacement in vestibular schwannoma.     

Diffusion tensor tractography and neuropsychological assessment in patients with vitamin B12 deficiency

Introduction

Structural imaging of the brain does not demonstrate any changes in a vast majority of patients with vitamin B12 deficiency, even in advanced stages. In this study, we aimed to assess and correlate the functional integrity of the brain fiber tracts using diffusion tensor tractography with neuropsychological examination in patients with vitamin B12 deficiency.

Methods

The study was conducted at two tertiary care centers. Thirty-two patients with vitamin B12 deficiency were enrolled and subjected to diffusion tensor tractography, as an extension of diffusion tensor imaging, and neuropsychological assessment. Tests of significance were done to detect changes, pre- and post-vitamin B12 supplementation in the diffusivity parameters (fractional anisotropy and mean diffusivity) and the neuropsychological test scores.

Results

Statistically significant changes were observed in the diffusivity parameters and the neuropsychological test scores between the controls and the patients with vitamin B12deficiency in the pre- and post-treatment phases.

Conclusions

This is the first study to evaluate the diffusion tensor tractography (DTT) parameters in the light of clinical neuropsychological assessment in patients with vitamin B12 deficiency. Utilization of DTT parameters may antedate structural changes and may quantify the neurocognitive deficits.     

Analysis of noise effects on DTI-based tractography using the brute-force and multi-ROI approach.

Diffusion tensor tractography based on line propagation is a promising and widely used technique, but it is known to be sensitive to noise and the size and location of the seed regions of interest (ROIs). The effects of these parameters on the tractography results were analyzed quantitatively using high-resolution diffusion tensor imaging (DTI) with a high signal-to-noise ratio (SNR) on a fixed mouse brain. The anterior commissure (AC), as judged from a T2-weighted image, was used as an anatomical reference within which the tracts could be located. Monte Carlo simulation was performed by adding Gaussian noise to the time domain data and repeating the tractography. Deviations of the tracking results were measured as a function of SNR. Such noise effects were evaluated for a simple one-ROI approach and a combined two-ROI and brute-force (BF) approach. The influence of ROI size and location for the two-ROI + BF approach was also analyzed. The results confirmed the hypothesis that one can increase the validity of DTI-based tractography by adopting the BF and multi-ROI approach, with respect to the simple one-ROI approach.     

Diffusion tensor MR imaging visualizes the altered hemispheric fiber connection in callosal dysgenesis

We report three cases of callosal dysgenesis that were evaluated by diffusion tensor imaging and fiber tractography. In partial agenesis of corpus callosum, fiber tracts from all regions of brain converged to a partially developed small genu portion and connected to the contralateral side. In complete callosal agenesis, fibers from the hemispheres failed to cross the midline and formed thick bundles running anteroposteriorly (eg, Probst bundle). The thickness of the anterior commissure was enlarged or smaller than normal brain, and other white matter tracts were not markedly different from normal brain tissue.     

Evaluation of local look diffusion tensor imaging for magnetic resonance tractography of the periprostatic neurovascular bundle

The purpose of this study was to compare diffusion tensor imaging using the local look technique and sensitivity encoding for tractography of the periprostatic neurovascular bundle. We compared the surrounding tissues of the prostate in eight healthy volunteers. The results of tractography in terms of the numbers of fibers and the fractional anisotropy map were evaluated. Distortion was evaluated using the dice similarity coefficient between isotropic diffusion images created from diffusion tensor images and T2-weighted images. The number of lines in tractography was significantly greater in diffusion tensor imaging using the local look technique (p?<?0.001). Although there was no difference in image distortion of the prostate between methods, an artifact appeared in the center of the diffusion tensor image using sensitivity encoding. In conclusion, diffusion tensor imaging using the local look technique was superior to that using sensitivity encoding for tractography of the periprostatic neurovascular bundle.     

Super‐resolution for multislice diffusion tensor imaging

Diffusion weighted magnetic resonance images are often acquired with single shot multislice imaging sequences, because of their short scanning times and robustness to motion. To minimize noise and acquisition time, images are generally acquired with either anisotropic or isotropic low resolution voxels, which impedes subsequent posterior image processing and visualization. In this article, we propose a super‐resolution method for diffusion weighted imaging that combines anisotropic multislice images to enhance the spatial resolution of diffusion tensor data. Each diffusion weighted image is reconstructed from a set of arbitrarily oriented images with a low through‐plane resolution. The quality of the reconstructed diffusion weighted images was evaluated by diffusion tensor metrics and tractography. Experiments with simulated data, a hardware DTI phantom, as well as in vivo human brain data were conducted. Our results show a significant increase in spatial resolution of the diffusion tensor data while preserving high signal to noise ratio. Magn Reson Med, 2013. © 2012 Wiley Periodicals, Inc.     

Independent component analysis‐based multifiber streamline tractography of the human brain

An independent component analysis‐based approach has been developed to estimate the orientations of two or three crossing fibers in a voxel to conduct human brain streamline tractography from diffusion data acquired along 25 gradient directions at a b‐value of 1000 sec/mm². The approach relies on unmixing signals from fibers mixed within, and spread over, a small cluster of 11 voxels. Simulation studies of diffusion data for two or three crossing fibers at signal‐to‐noise ratios of 15 and 30 suggest the accuracy to determine interfiber angles with independent component analysis is similar to that attained by a gaussian mixture and other multicompartmental models but at two orders of magnitude faster computational speed. Compared to previous multicompartmental models, independent component analysis visually shows good recovery of fiber orientations and tracts in the crossing region of commonly available orthogonal and 60° phantom diffusion datasets. A 3T MRI human studies show that in contrast to conventional streamline tractography and a multicompartment model, independent component analysis shows better recovery of the continuity of fronto‐occipital tracts and cingulum from regions where these tracts are mixed with corpus callosum and other pathways. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.     

Parry-Romberg syndrome with a clinically silent white matter lesion

We performed a detailed neuroimaging study in a patient with Parry-Romberg syndrome. Proton MR spectroscopy demonstrated normal spectral patterns, though conventional MR imaging revealed high-intensity areas in the entire white matter in the left hemisphere. Single-photon emission tomography showed increased perfusion in the cortex of the affected hemisphere. Pyramidal tracts and optic radiations were preserved on diffusion tensor tractography. We will correlate these neuroimaging findings with normal psychomotor development in our patient.