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The Impact of Intracranial Tumor Proximity to White Matter Tracts on Morbidity and Mortality: A Retrospective Diffusion Tensor Imaging Study.
Meyer, Erin J; Gaggl, Wolfgang; Gilloon, Benjamin; Swan, Benjamin; Greenstein, Max; Voss, Jed; Hussain, Namath; Holdsworth, Ryan L; Nair, Veena A; Meyerand, M Elizabeth; Kuo, John S; Baskaya, Mustafa K; Field, Aaron S; Prabhakaran, Vivek.
Afiliação
  • Meyer EJ; Departments of Radiology, Case Western Reserve Medical School Cleveland, Ohio, USA.
  • Gaggl W; School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
  • Gilloon B; Departments of Radiology, Case Western Reserve Medical School Cleveland, Ohio, USA.
  • Swan B; Departments of Radiology, Case Western Reserve Medical School Cleveland, Ohio, USA.
  • Greenstein M; Departments of Radiology, Case Western Reserve Medical School Cleveland, Ohio, USA.
  • Voss J; Departments of Radiology, Case Western Reserve Medical School Cleveland, Ohio, USA.
  • Hussain N; Departments of Radiology, Case Western Reserve Medical School Cleveland, Ohio, USA.
  • Holdsworth RL; Department of Neurosurgery, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA.
  • Nair VA; Departments of Radiology, Case Western Reserve Medical School Cleveland, Ohio, USA.
  • Meyerand ME; University of Wisconsin Madison Hospital and Clinics, Madison, Wisconsin, USA.
  • Kuo JS; Departments of Radiology, Case Western Reserve Medical School Cleveland, Ohio, USA.
  • Baskaya MK; Medical Physics, School of Health, University of Wisconsin, Madison, USA.
  • Field AS; Biomedical Engineering, University of Wisconsin, Madison, USA.
  • Prabhakaran V; Neurological Surgery, University of Wisconsin Medical School, Madison, Wisconsin, USA.
Neurosurgery ; 80(2): 193-200, 2017 02 01.
Article em En | MEDLINE | ID: mdl-28173590
Background: Using diffusion tensor imaging (DTI) in neurosurgical planning allows identification of white matter tracts and has been associated with a reduction in postoperative functional deficits. Objective: This study explores the relationship between the lesion-to-tract distance (LTD) and postoperative morbidity and mortality in patients with brain tumors in order to evaluate the role of DTI in predicting postoperative outcomes. Methods: Adult patients with brain tumors (n = 60) underwent preoperative DTI. Three major white matter pathways (superior longitudinal fasciculi [SLF], cingulum, and corticospinal tract) were identified using DTI images, and the shortest LTD was measured for each tract. Postoperative morbidity and mortality information was collected from electronic medical records. Results: The ipsilesional corticospinal tract LTD and left SLF LTD were significantly associated with the occurrence rate of total postoperative motor (P = .018) and language (P < .001) deficits, respectively. The left SLF LTD was also significantly associated with the occurrence rate of new postoperative language deficits (P = .003), and the LTD threshold that best predicted this occurrence was 1 cm (P < .001). Kaplan­Meier log-rank survival analyses in patients having high-grade tumors demonstrated a significantly higher mortality for patients with a left SLF LTD <1 cm (P = .01). Conclusion: Measuring tumor proximity to major white matter tracts using DTI can inform clinicians of the likelihood of postoperative functional deficits. A distance of 1 cm or less from eloquent white matter structures most significantly predicts the occurrence of new deficits with current surgical and imaging techniques.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Encefálicas / Imagem de Tensor de Difusão / Substância Branca Idioma: En Ano de publicação: 2017 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Encefálicas / Imagem de Tensor de Difusão / Substância Branca Idioma: En Ano de publicação: 2017 Tipo de documento: Article