Preserved microstructural integrity of the corticospinal tract in patients with glioma-induced motor epilepsy: a study using mean apparent propagator magnetic resonance imaging

Quantitative Imaging in Medicine and Surgery

article

Yuhui Wang¹  Kaiji Deng³  Yifan Sun³  Xinming Huang³  Yihai Dai⁴  Weitao Chen⁴  Xiaomei Hu⁵  Rifeng Jiang³ 

[1] Department of Radiology, Union Hospital, Tongji Medical College , Huazhong University of Science and Technology;Hubei Province Key Laboratory of Molecular Imaging;Department of Radiology , Fujian Medical University Union Hospital;Department of Neurosurgery , Fujian Medical University Union Hospital;Department of Pathology , Fujian Medical University Union Hospital

关键词: Glioma;    epilepsy;    corticospinal tract (CST);    mean apparent propagator (MAP);    diffusion tensor imaging (DTI);   

DOI  :  10.21037/qims-21-679

学科分类：外科医学

来源: AME Publications

【 摘 要 】

Background: To compare the microstructural integrity of the corticospinal tract (CST) between glioma patients with motor epilepsy and without epilepsy using mean apparent propagator magnetic resonance imaging (MAP-MRI). Methods: A total of 26 patients with glioma adjacent to the CST pathway (10 with motor epilepsy and 16 without epilepsy) and 13 matched healthy controls underwent brain structural and diffusion MRI. The morphological characteristics of the CST (tract volume, tract number, and average length) were extracted, and diffusion parameter values including mean squared displacement (MSD), q-space inverse variance (QIV), return-to-origin probability (RTOP), return-to-axis probabilities (RTAP), return-to-plane probabilities (RTPP), fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) along the CST were evaluated. The CST features were compared between healthy and affected sides and the relative CST features were compared across the three groups of participants. A receiver operating characteristic (ROC) curve was plotted to assess the performance of each relative CST characteristic for glioma-induced CST changes. Results: For patients without epilepsy, the tract number, tract volume, FA, RD, MSD, QIV, and RTAP changed significantly on the affected CST side compared with those on the healthy CST side (P=0.002, 0.002, 0.030 0.017, 0.039, 0.044, and 0.002, respectively). In contrast, for patients with motor epilepsy, no significant difference was found between the affected and healthy side in almost all CST features except RTPP (P=0.028). Compared with patients with motor epilepsy, the relative tract number, tract volume, AD, and RTAP were significantly lower (P=0.027, 0.018, 0.040, and 0.027, respectively) in patients without epilepsy, and their areas under the curve (AUCs) were 0.763, 0.781, 0.744, and 0.763, respectively. No significant difference was found between patients with motor epilepsy and matched healthy controls. Conclusions: The MAP-MRI is a promising approach for evaluating CST changes. It provides additional information reflecting the microstructural complexity of the CST and demonstrates the preserved microstructural integrity of the CST in glioma patients with motor epilepsy.

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