Korean J Radiol.  2017 Oct;18(5):844-851. 10.3348/kjr.2017.18.5.844.

Optimal Factors of Diffusion Tensor Imaging Predicting Corticospinal Tract Injury in Patients with Brain Tumors

Affiliations
  • 1Department of Radiology, Yixing Hospital Affiliated of Jiangsu University, Yixing 214200, China.
  • 2Department of Radiology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China. xjtuzhangming@gmail.com
  • 3Department of Medical Imaging, School of Medicine, Jiangsu University, Zhenjiang 212013, China.

Abstract


OBJECTIVE
To identify the optimal factors in diffusion tensor imaging for predicting corticospinal tract (CST) injury caused by brain tumors.
MATERIALS AND METHODS
This prospective study included 33 patients with motor weakness and 64 patients with normal motor function. The movement of the CST, minimum distance between the CST and the tumor, and relative fractional anisotropy (rFA) of the CST on diffusion tensor imaging, were compared between patients with motor weakness and normal function. Logistic regression analysis was used to obtain the optimal factor predicting motor weakness.
RESULTS
In patients with motor weakness, the displacement (8.44 ± 6.64 mm) of the CST (p = 0.009), minimum distance (3.98 ± 7.49 mm) between the CST and tumor (p < 0.001), and rFA (0.83 ± 0.11) of the CST (p < 0.001) were significantly different from those of the normal group (4.64 ± 6.65 mm, 14.87 ± 12.04 mm, and 0.98 ± 0.05, respectively) (p = 0.009, p < 0.001, and p < 0.001). The frequencies of patients with the CST passing through the tumor (6%, p = 0.002), CST close to the tumor (23%, p < 0.001), CST close to a malignant tumor (high grade glioma, metastasis, or lymphoma) (19%, p < 0.001), and CST passing through infiltrating edema (19%, p < 0.001) in the motor weakness group, were significantly different from those of the patients with normal motor function (0, 8, 1, and 10%, respectively). Logistic regression analysis showed that decreased rFA and CST close to a malignant tumor were effective variables related to motor weakness.
CONCLUSION
Decreased fractional anisotropy, combined with closeness of a malignant tumor to the CST, is the optimal factor in predicting CST injury caused by a brain tumor.

Keyword

Brain tumor; Diffusion tensor imaging; DTI; MRI; Corticospinal tract; Motor function

MeSH Terms

Adolescent
Adult
Aged
Area Under Curve
Brain Neoplasms/*pathology
*Diffusion Tensor Imaging
Female
Glioma/pathology
Humans
Logistic Models
Male
Meningioma/pathology
Middle Aged
Prospective Studies
Pyramidal Tracts/*diagnostic imaging/injuries
ROC Curve
Young Adult
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