Shift of the Pyramidal Tract During Resection of the Intraaxial Brain Tumors Estimated by Intraoperative Diffusion-Weighted Imaging
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概要
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The present study evaluated the shift of the pyramidal tract during resection of 17 proximal intraaxial brain tumors. In each case intraoperative diffusion-weighted (iDW) magnetic resonance imaging with a motion-probing gradient applied in the anteroposterior direction was performed using a scanner with a 0.3 T vertical magnetic field. The position of the white matter bundles containing the pyramidal tract was estimated on the coronal images before and after resection of the neoplasm, and both quantitative and directional evaluation of its displacement was done. In all cases iDW imaging provided visualization of the structure of interest. The magnitude of the pyramidal tract displacement due to removal of the neoplasm varied from 0.5 to 8.7mm (mean 4.4±2.5mm) on the lesion side and from 0 to 3.6mm (mean 1.3±1.1mm) on the normal side (p<0.001). Tumor location in regards to the pyramidal tract was significantly associated with the direction of the pyramidal tract displacement (p<0.05). Outward shift occurred in 10 out of 13 cases of the lateral neoplasms, whereas in all 4 superomedial tumors inward shift was marked. In conclusion, the direction of the pyramidal tract displacement during resection of the proximal intraaxial brain tumors is mainly determined by position of the neoplasm, but can be unpredictable in some cases, which necessitates use of subcortical brain mapping and intraoperative imaging, particularly iDW imaging with updated neuronavigation.
- 社団法人日本脳神経外科学会の論文
- 2009-02-15
著者
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HORI Tomokatsu
Department of Neurosurgery, Tokyo Women's Medical University
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Hori Tomokatsu
Department Of Neurosurgery Tokyo Women's Medical University
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OZAWA Norihiko
Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical Engineering and Science, Tokyo
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MURAGAKI Yoshihiro
Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical Engineering and Science, Tokyo
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NAKAMURA Ryoichi
Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical Engineering and Science, Tokyo
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ISEKI Hiroshi
Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical Engineering and Science, Tokyo
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Hori Tomokatsu
Department Of Neurosurgery Faculty Of Medicine University Of Tokyo.
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Iseki Hiroshi
Faculty Of Advanced Techno-surgery Institute Of Advanced Biomedical Engineering And Science Tokyo Wo
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Ozawa Norihiko
Faculty Of Advanced Techno-surgery Institute Of Advanced Biomedical Engineering And Science Tokyo Wo
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Hori Tomokatsu
Department Of Neurosurgery Institute Of Clinical Neurology Tokyo Women's Medical University
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Nakamura Ryoichi
Faculty Of Advanced Techno-surgery Institute Of Advanced Biomedical Engineering And Science Tokyo Wo
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Higa Takashi
Department Of Neurosurgery Neurological Institute Tokyo Women's Medical University
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Muragaki Yoshihiro
Faculty Of Advanced Techno-surgery Institute Of Advanced Biomedical Engineering And Science Tokyo Wo
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Hori Tomokatsu
Department Of Neurosurgery Tokyo Woman's Medical University
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HORI Tomokatsu
Department of Neurosurgery, Tokyo Women's Medical University
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