Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica ›› 2011, Vol. 33 ›› Issue (5): 499-503.doi: 10.3881/j.issn.1000-503X.2011.05.005

• Original Articles • Previous Articles     Next Articles

Application of Diffusion Tensor Imaging-based Arcuate Fasciculus Tractography and Intraoperative Arcuate Fasciculus Navigation

ZHAO Yan1, 2, CHEN Xiao-lei1, WANG Fei1, SUN Guo-chen1   

  1. 1Department of Neurosurgery, Chinese PLA General Hospital, Beijing 100853, China; 2Medical School of Nankai University, Tianjin 300071, China
  • Received:2011-04-15 Revised:2011-10-28 Online:2011-10-28 Published:2011-10-28
  • Contact: XU Bai-nan E-mail:sjwkk@sina.com
  • Supported by:

    Supported by the National Natural Sciences Foundation of China (NSFC 30800349)

Abstract: Objective To investigate the feasibility of applying diffusion tensor imaging (DTI)-based arcuate fasciculus tractography and intraoperative arcuate fasciculus navigation for neurosurgery. Methods Totally 85 patients with interhemispheric tumors who had undergone intra-operative magnetic resonance imaging (MRI) and neuronavigation were divided into sinistrocerebral tumor (SCT) group (n=55) and sham group (n=30). All patients accepted routine MRI and DTI preoperatively. The Results from both DTI-based arcuate fasciculus tractography and neuronavigation were applied to guide the surgery. All patients were followed up for 2 - 4 week in the SCT group and 3 - 6 months in the sham group postoperatively. Results All patients smoothly received the pre-operative DTI-based arcuate fasciculus tractography. The three dimensional arcuate fasciculus was successfully integrated with the neuronavigation and achieved microscope heads-up display. Long-term follow-up showed that there were only 4 patients suffered from persistent language dysfunction. Conclusions The combined application of DTI-based arcuate fasciculus tractography and intraoperative arcuate fasciculus navigation is feasible for guiding brain surgery. It can improve the surgical outcomes of intracranial tumor involving language functional area. The technology also maximizes the retention of language function and improves the post-operative quality of life.

Key words: diffusion tensor imaging, tractography, arcuate fasciculus, neuronavigation

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