Role of Diffusion Tensor Tractography in Cerebral Arteriovenous Malformations

[摘要] Background: Until recently, the study of white matter bundles was restricted to post-mortem dissection. Recent advances in MR techniques have made it possible to outline major brain white matter connections by diffusion tensor imaging (DTI). Objective: To investigate the utility of DTI in visualization of nearby and distant major white matter tracts in patients with cerebral arteriovenous malformation (AVM). Methods: A prospective study of major white matter tracts around and distant from AVM lesion was performed on MRI machine for 25 patients with cerebral AVM treated with embolization. Diffusion tractography was used to visualize the target white matter tract pathway. The target white matter tracts were considered nearby AVM if it is included within the AVM or AVM-related lesion “AVM with surrounding edema +/- hemorrhage" and not separable by healthy tissue, while considered to be distant from AVM if they are not included in the AVM or AVM-related lesion. The obtained data was analyzed in relation to the clinical symptoms and deficits. Results: The patients group included 12 men and 13 women with age range from 15 to 46 years, mean age 32.56 years. The fiber tracts nearby AVM were less visualized in the affected hemisphere than those distant from it. Tracts were less visualized in patients with neurological symptoms than in asymptomatic patients. Conclusion: Diffusion tractography allows visualization of fiber bundle modifications in the presence of cerebral AVMs. Depending on the location of the AVM, specific long association fibers can be differently modified. (Egypt J Neurol Psychiat Neurosurg. 2010; 47(1): 215-223)

[学科分类] 精神健康和精神病学