We have located links that may give you full text access.
Diffusion tensor imaging to evaluate commissural disconnection after corpus callosotomy.
Neuroradiology 2013 November
INTRODUCTION: Corpus callosum transection can prevent propagation of epileptic discharges. If seizures persist after surgery, assessment of the efficacy of the transection requires knowledge that the commissural fibers have been disrupted. We evaluated whether diffusion tensor imaging (DTI) and diffusion tensor fiber tracking can assess the degree of callosal transection and determine which white matter pathways remain intact.
METHODS: This HIPAA-compliant retrospective study was performed after Institutional Review Board approval. Patients who underwent corpus callosotomy with postoperative magnetic resonance imaging (MRI) that included DTI were identified. Axial DTI was performed with either 15 or 25 noncollinear directions of encoding. MRI and DTI were reviewed by two board-certified neuroradiologists to evaluate commissural disconnection.
RESULTS: One hundred eleven patients underwent corpus callosotomy with postoperative MRI, of which 32 had postoperative DTI. Of these 32, there were 16 males and 16 females, with a mean age of 12.2 ± 6.3 years (range 0.24 to 32.8 years, median 12.3). Eighteen patients had undergone complete callosal transection and 14 patients had partial callosal transection. Seventeen of 18 patients undergoing complete callosal transection had structural and diffusion tensor fiber tracking (DT-FT) evidence of complete transection. The forceps major was intact in all patients undergoing partial transection. At least some commissural fibers originating from the precuneus, postcentral gyrus, and posterior cingulate were intact in all six partial transections which spared the callosal isthmus.
CONCLUSION: DTI and DT-FT aid in the postoperative characterization in patients with callosal transection for seizure control. This can confirm whether the intended fibers have been disconnected, helping in the planning for possible further surgical intervention versus other therapies.
METHODS: This HIPAA-compliant retrospective study was performed after Institutional Review Board approval. Patients who underwent corpus callosotomy with postoperative magnetic resonance imaging (MRI) that included DTI were identified. Axial DTI was performed with either 15 or 25 noncollinear directions of encoding. MRI and DTI were reviewed by two board-certified neuroradiologists to evaluate commissural disconnection.
RESULTS: One hundred eleven patients underwent corpus callosotomy with postoperative MRI, of which 32 had postoperative DTI. Of these 32, there were 16 males and 16 females, with a mean age of 12.2 ± 6.3 years (range 0.24 to 32.8 years, median 12.3). Eighteen patients had undergone complete callosal transection and 14 patients had partial callosal transection. Seventeen of 18 patients undergoing complete callosal transection had structural and diffusion tensor fiber tracking (DT-FT) evidence of complete transection. The forceps major was intact in all patients undergoing partial transection. At least some commissural fibers originating from the precuneus, postcentral gyrus, and posterior cingulate were intact in all six partial transections which spared the callosal isthmus.
CONCLUSION: DTI and DT-FT aid in the postoperative characterization in patients with callosal transection for seizure control. This can confirm whether the intended fibers have been disconnected, helping in the planning for possible further surgical intervention versus other therapies.
Full text links
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app