%0 Journal Article
%T MR Tractography for preoperative planning in patients with cerebral tumors in eloquent areas
%A B. Iliescu1
%A D. Negru2
%A I. Poeata2
%J Romanian Neurosurgery
%D 2010
%I Romanian Society of Neurosurgery
%X Resection of the maximum amount oftumoral tissue while preserving thefunction of the brain within or neighboringthe tumor region established itself as afundamental goal of modern oncologicneurosurgery. A major step in preoperativemapping of eloquent cerebral cortex wastaken reliably through the use of functionalmagnetic resonance imaging. However itdoes not provide any information about thewhite matter tracts that may be affected byinvasive, intrinsic brain tumors. Theadvances in diffusion-tensor (DT) imagingtechniques have been used to map whitematter tracts in the normal brain. The aimof this study was to demonstrate the role ofDT imaging in preoperative mapping ofwhite matter tracts in relation to cerebralneoplasms and the way it can influence theoperative decision in our practice. Tenpatients with brain malignancies within orneighboring eloquent cortical areas (nineglioblastoma and one grade twoastrocytoma) underwent DT imagingexaminations prior to tumor excision.Anatomical information about white mattertract location, orientation, and projectionswas obtained in every patient. Dependingon the tumor type and location, evidence ofwhite matter tract edema (one patient),infiltration (one patient), displacement (fivepatients), and disruption (three patients)could be assessed with the aid of DTimaging in each case. Diffusion-tensorimaging allowed for visualization of whitematter tracts and was found to be beneficialin the surgical planning for patients withintrinsic brain tumors. The authors¡¯experience with DT imaging indicates thatanatomically intact fibers may be present inabnormal-appearing areas of the brain.Whether resection of these involved fibersresults in subtle postoperative neurologicaldeficits requires further systematic study.
%K cerebral eloquent areas
%K glioblastoma
%K MR tractography
%U http://www.roneurosurgery.eu/atdoc/5IliescuBMRTractography.pdf