Shift of the pyramidal tract during resection of the intraaxial brain tumors estimated by intraoperative diffusion-weighted imaging

Norihiko Ozawa, Yoshihiro Muragaki, Ryoichi Nakamura, Tomokatsu Hori, Hiroshi Iseki

    Research output: Contribution to journalArticle

    19 Citations (Scopus)

    Abstract

    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 8.7 mm (mean 4.4 ± 2.5 mm) on the lesion side and from 0 to 3.6 mm (mean 1.3 ± 1.1 mm) 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.

    Original languageEnglish
    Pages (from-to)51-56
    Number of pages6
    JournalNeurologia Medico-Chirurgica
    Volume49
    Issue number2
    DOIs
    Publication statusPublished - 2009 Mar 9

      Fingerprint

    Keywords

    • Brain shift
    • Diffusion-weighted magnetic resonance imaging
    • Functional mapping
    • Intraoperative magnetic resonance imaging
    • Neuronavigation
    • Pyramidal tract

    ASJC Scopus subject areas

    • Surgery
    • Clinical Neurology

    Cite this