Influence of basal ganglia hemorrhage and infarction on corticospinal tract: Evaluation based on diffusion tensor imaging

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Abstract

BACKGROUND:

Hemorrhagic and ischemic diseases at basal ganglia region could induce adjacent corticospinal tract (CST) injury, resulting limb motor dysfunction. Functional MR diffusion tensor imaging (DTI) could effectively display white matter in the brain. In particular when adjacent and related white matter fiber structures are damaged in pathological changes, fractional anisotropy (FA) of diffusion tensor imaging is the most sensitive.

OBJECTIVE:

To explore the influence of hemorrhagia and ischemia at left basal ganglia region on the CST pathway using DTI, and compare the difference of FA features of CST pathway under two conditions.

DESIGN, TIME AND SETTING:

Comparative observation. The study was performed at the Department of MRI, First Affiliated Hospital of Kunming Medical University between October 2005 and December 2008.

PARTICIPANTS:

A total of 20 patients with hemorrhage of left basal ganglia and 27 with infarction of left basal ganglia.

METHODS:

Data of entire brain were collected and processed using 1.5 T GE MRI and SUN workstation. Every layer FA values were measured on whole CST pathway, including medulla, pons, cerebral peduncle, basal ganglia, corona radiate and semioval center. The size of region of interest (ROI) was identified by the axial view of individual fascicles, which did not exceed that structure scope and two people confirmed the ROI.

MAIN OUTCOME MEASURES:

Conventional MRI was used to confirm hemorrhage and infarction of left basal ganglia. Data of DTI was collected and used to measure and analyze FA of corticospinal tract pathway using DTI software.

RESULTS:

DTI depicted the FA values of different level CST were different under both conditions (α=0.05). No differences were found in FA value at medulla level under both sides (P=0.05). Pons, cerebral peduncle, basal ganglia and corona radiate levels showed significant differences in CST FA value under both sides (P < 0.001). The P values of CST FA of basal ganglia and corona radiate levels were the most smallest, especially the corona radiate level.

CONCLUSION:

DTI results show that left corticospinal tract was significantly affected by left basal ganglia stroke compared with hemorrhage.

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