The role of diffusion tensor imaging and MR Tractography in the evaluation of ischemic cerebral strokes
Ahmed Hussein Farahat;
Abstract
Cerebral stroke is a worldwide concern, it's classified as the most second cause of death. Annually, 5.7 million deaths & about nine million patients had cerebral strokes events in 2008 with resultant variable degrees of disabilities.
The primary goal in stroke management is to reach an early accurate diagnosis for the patients, which will affect the choice of the treatment lines among the newly developed programs and the end stage recovery.
The DTI & the DT based tractography are new techniques depend on the directional movement of water which is determined by the brain micro-structures and imaged on the diffusion sensitive MRI to generate virtual, three dimensional representations of the white matter fiber tracts. The ability of the trace of the white matter pathway in non-invasive way is the reason why the tractography has generated much enthusiasm and high expectations.
The diffusion tensor is a mathematical description of the magnitude and directionality (anisotropy) of the movement of water molecules in a three-dimensional space. In the brain white matter, diffusion is directional (anisotropic) along the fibres because molecules move more easily parallel to tracts and are mostly hindered or restricted in their movement perpendicular to tracts. Therefore, the diffusion tensor gives two important pieces of information in each imaging voxel: the magnitude of diffusion anisotropy and the orientation of the maximum diffusion. Tractography algorithms use this information to track the whole white matter pathway by inferring the continuity of fibre paths from voxel to voxel in the brain.
This study is aiming to evaluate this new technique in ischemic cerebral strokes patients and its effectiveness in predicting the clinical outcome in such cases.
One hundered patients with ischemic cerebral strokes were recruited in this study which was done in the Kobery Elkobah Military compound.
These patients were evaluated clinically at the time of the admission by using the NIHSS, then imaging of these patients within one week of the admission by conventional MRI and adding DTI sequence to the study.
The DTI was transferred to workstation where all tracts related to the infarction site were reconstructed.
The primary goal in stroke management is to reach an early accurate diagnosis for the patients, which will affect the choice of the treatment lines among the newly developed programs and the end stage recovery.
The DTI & the DT based tractography are new techniques depend on the directional movement of water which is determined by the brain micro-structures and imaged on the diffusion sensitive MRI to generate virtual, three dimensional representations of the white matter fiber tracts. The ability of the trace of the white matter pathway in non-invasive way is the reason why the tractography has generated much enthusiasm and high expectations.
The diffusion tensor is a mathematical description of the magnitude and directionality (anisotropy) of the movement of water molecules in a three-dimensional space. In the brain white matter, diffusion is directional (anisotropic) along the fibres because molecules move more easily parallel to tracts and are mostly hindered or restricted in their movement perpendicular to tracts. Therefore, the diffusion tensor gives two important pieces of information in each imaging voxel: the magnitude of diffusion anisotropy and the orientation of the maximum diffusion. Tractography algorithms use this information to track the whole white matter pathway by inferring the continuity of fibre paths from voxel to voxel in the brain.
This study is aiming to evaluate this new technique in ischemic cerebral strokes patients and its effectiveness in predicting the clinical outcome in such cases.
One hundered patients with ischemic cerebral strokes were recruited in this study which was done in the Kobery Elkobah Military compound.
These patients were evaluated clinically at the time of the admission by using the NIHSS, then imaging of these patients within one week of the admission by conventional MRI and adding DTI sequence to the study.
The DTI was transferred to workstation where all tracts related to the infarction site were reconstructed.
Other data
| Title | The role of diffusion tensor imaging and MR Tractography in the evaluation of ischemic cerebral strokes | Authors | Ahmed Hussein Farahat | Issue Date | 2014 |
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