Korean J Radiol.  2021 May;22(5):759-769. 10.3348/kjr.2020.0949.

Laplacian-Regularized Mean Apparent Propagator-MRI in Evaluating Corticospinal Tract Injury in Patients with Brain Glioma

• Jiang R
• Jiang S
• Song S
• Wei X
• Deng K
• Zhang Z
• Xue Y

• KMID: 2515065
• DOI: http://doi.org/10.3348/kjr.2020.0949

Abstract

Objective
To evaluate the application of laplacian-regularized mean apparent propagator (MAPL)-MRI to brain glioma-induced corticospinal tract (CST) injury.
Materials and Methods
This study included 20 patients with glioma adjacent to the CST pathway who had undergone structural and diffusion MRI. The entire CSTs of the affected and healthy sides were reconstructed, and the peritumoral CSTs were manually segmented. The morphological characteristics of the CST (track number, average length, volume, displacement of the affected CST) were examined and the diffusion parameter values, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD), mean squared displacement (MSD), q-space inverse variance (QIV), returnto-origin probability (RTOP), return-to-axis probabilities (RTAP), and return-to-plane probabilities (RTPP) along the entire and peritumoral CSTs, were calculated. The entire and peritumoral CST characteristics of the affected and healthy sides as well as those relative CST characteristics of the patients with motor weakness and normal motor function were compared.
Results
The track number, volume, MD, RD, MSD, QIV, RTAP, RTOP, and RTPP of the entire and peritumoral CSTs changed significantly for the affected side, whereas the AD and FA changed significantly only in the peritumoral CST (p < 0.05). In patients with motor weakness, the relative MSD of the entire CST, QIV of the entire and peritumoral CSTs, and the AD, MD, RD of the peritumoral CST were significantly higher, whereas the RTPP of the entire and peritumoral CSTs and the RTOP of the peritumoral CST were significantly lower than those in patients with normal motor function (p < 0.05 for all). In contrast, no significant changes were found in the CST morphological characteristics, FA, or RTAP (p > 0.05 for all).
Conclusion
MAPL-MRI is an effective approach for evaluating microstructural changes after CST injury. Its sensitivity may improve when using the peritumoral CST features.

Keyword

Diffusion magnetic resonance imaging; Glioma; Corticospinal tract; Muscle weakness