J Korean Neurosurg Soc.  2014 May;55(5):267-272. 10.3340/jkns.2014.55.5.267.

Preoperative Weakness and Demyelination of the Corticospinal Tract in Meningioma Patients : Changes in Diffusion Parameters Using Diffusion Tensor Imaging

• Kim MS
• Chung CK
• Jung HW
• Park CK
• Kim CH
• Kim JS

• KMID: 2018032
• DOI: http://doi.org/10.3340/jkns.2014.55.5.267

Abstract

OBJECTIVE
Differentiation of demyelination in white matter from axonal damage can be determined using diffusion tensor imaging (DTI). In this study using meningioma patients an attempt was made to evaluate the relationship between preoperative weakness and the changes of diffusion parameters in the corticospinal tract (CST) using DTI.
METHODS
Twenty-six patients with meningioma were enrolled in this study. Eleven of them suffered from objective motor weakness and were classified as Group 1. The remaining 15 patients did not present motor weakness and were classified as Group 2. Fiber tractography and CST diffusion parameters were obtained using DTIStudio. The ratios (lesion side mean value/contralateral side mean value) of CST diffusion parameters were compared with 1.0 as a test value using a one-sample t-test.
RESULTS
In Group 1, fractional anisotropy (FA), tensor trace (TT), and radial diffusivity (RD, lambda2 and lambda3) of the CST were significantly different between two hemispheres, but axial diffusivity (AD, lambda1) of the CST was not significantly different between two hemispheres. In Group 2, FA and lambda3 of CST did not differ significantly between the hemispheres. In Group 2, TT, lambda1, and lambda2 of CST in the ipsilateral hemisphere were significantly higher than those of the unaffected hemisphere. However, the differences were small.
CONCLUSION
Motor weakness was related to a low FA and high TT resulting from increased RD of the CST fibers. CST diffusion changes in patients with weakness are similar to those for demyelination.

Keyword

Corticospinal tract; Diffusion tensor imaging; Weakness; Demyelination; Diffusion

MeSH Terms

Anisotropy
Axons
Demyelinating Diseases*
Diffusion Tensor Imaging*
Diffusion*
Humans
Meningioma*
Pyramidal Tracts*

Figure

• 

  Fig. 1 Corticospinal tract (CST) fiber tracking in a 37-year-old man with benign meningioma. A 37-year-old man presented with seizure and right-upper-extremity weakness. A T1-enhanced image shows a slightly enhanced mass in the left frontal lobe (A). The posterior limb of the internal capsule is selected as the seed region of interest (ROI) (B and C). The ipsilateral cerebral peduncle is selected as the target ROI (D). The tractography image shows the CST on a coronal T2-weighted image (E).

• 

  Fig. 2 Ratios (lesion/contralateral) of the diffusion parameters (FA, TT, λ1, λ2, and λ3) for the CST in meningioma patients with weakness (Group 1). y-axis : ratio of diffusion parameters for the CST in the two hemispheres, FA : fractional anisotropy, TT : tensor trace, 1 : primary eigenvalue, λ2 : second eigenvalue, λ3 : third eigenvalue.

• 

  Fig. 3 Ratios (lesion/contralateral) of diffusion parameters (FA, TT, λ1, λ2, and λ3) for the CST in meningioma patients without weakness (Group 2). y-axis : ratio of diffusion parameters for the CST in the two hemispheres, FA : fractional anisotropy, TT : tensor trace, λ1 : primary eigenvalue, λ2 : second eigenvalue, λ3 : third eigenvalue.

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