Anisotropy Threshold Research Articles

Diffusion tensor tractography-based analysis of the cingulum: clinical utility and findings in traumatic brain injury with chronic sequels.

To evaluate the clinical utility of quantitative diffusion tensor tractography (DTT) and tractography-based core analysis (TBCA) of the cingulum by defining the reproducibility, normal values, and findings in traumatic brain injury (TBI). Eighty patients with TBI and normal routine MRI and 78 controls underwent MRI at 3T. To determine reproducibility, 12 subjects were scanned twice. Superior (SC) and inferior (IC) cingulum were analyzed separately by DTT (fractional anisotropy (FA) thresholds 0.15 and 0.30). TBCA was performed from volumes defined by tractography with gradually changed FA thresholds. FA values were correlated with clinical and neuropsychological data. The lowest coefficient of variation was obtained at DTT threshold 0.30 (2.0 and 2.4% for SC and IC, respectively), but in proportion to standard deviations of normal controls, the reproducibility of TBCA was better in SC and similar to that of DTT in IC. In patients with TBI, volume reduction with loss of peripheral fibers was relatively common; mean FA was mostly normal in these tractograms. The frequency of FA reductions (>2 SD) was in DTT smaller than in TBCA, in which FA decrease was present in 42 (13.1%) of the 320 measurements. Central FA values in SC predicted visuoperceptual ability, and those in left IC predicted cognitive speed, language, and communication ability (p < 0.05). Tractography-based measurements have sufficient reproducibility for demonstration of severe abnormalities of the cingulum. TBCA is preferential for clinical FA analysis, because it measures corresponding areas in patients and controls without inaccuracies due to trauma-induced structural changes.

Can DTI fiber tracking of the optic radiations predict visual deficit after surgery?

ObjectSparing optic radiations can be of paramount importance during epilepsy surgery of the temporal lobe. The anatomical heterogeneity of the Meyer’s loop of the optic radiations could be assessed by means of diffusion tensor tractography. We used temporal lobe surgery as a lesion model to validate this method. Material and methodsWe analyzed the distance between the temporal pole (TP) and Meyer’s loop (ML) and the correlation between visual impairment and the percentage of virtual fibers injured. MRI studies were performed in 18 patients and 13 controls. Diffusion tensor imaging (DTI) with fiber tracking was performed using four different algorithms and various gradient directions (15 or 32) and fractional anisotropy (FA) thresholds (0.18, 0.20, and 0.22). To find the best DTI model, we tested each gradient direction and FA threshold on 16 operated patients by pre- and post-operative visual field testing that analyzed the percentage of virtual fibers damaged on 3-month-post-operative MRIs. ResultsMarked individual differences were noted in the TP-ML distances (mean: 25.4mm; range 18.2–38.3mm; standard deviation: 4.7) but with no significant difference between patients and controls (p=0.9). The percentage of virtual fibers reconstructed by tracking and damaged by surgery was correlated with visual impairment. Significant differences appeared between algorithm types. The tensor-line algorithm with 15-direction resolution and an anisotropy threshold of 0.18 seemed to be the most relevant. A threshold of 5.5% of injured virtual fiber could predict a visual defect with a sensitivity of 71.4% and a specificity of 87.5%. ConclusionOptic radiation tractography by DTI could be a useful method to assess an individual patient’s risk of postoperative visual deficit.

Structural connectivity of the default mode network and cognition in Alzheimer׳s disease

Disconnectivity between the Default Mode Network (DMN) nodes can cause clinical symptoms and cognitive deficits in Alzheimer׳s disease (AD). We aimed to examine the structural connectivity between DMN nodes, to verify the extent in which white matter disconnection affects cognitive performance. MRI data of 76 subjects (25 mild AD, 21 amnestic Mild Cognitive Impairment subjects and 30 controls) were acquired on a 3.0T scanner. ExploreDTI software (fractional Anisotropy threshold=0.25 and the angular threshold=60°) calculated axial, radial, and mean diffusivities, fractional anisotropy and streamline count. AD patients showed lower fractional anisotropy (P=0.01) and streamline count (P=0.029), and higher radial diffusivity (P=0.014) than controls in the cingulum. After correction for white matter atrophy, only fractional anisotropy and radial diffusivity remained significantly lower in AD compared to controls (P=0.003 and P=0.05). In the parahippocampal bundle, AD patients had lower mean and radial diffusivities (P=0.048 and P=0.013) compared to controls, from which only radial diffusivity survived for white matter adjustment (P=0.05). Regression models revealed that cognitive performance is also accounted for by white matter microstructural values. Structural connectivity within the DMN is important to the execution of high-complexity tasks, probably due to its relevant role in the integration of the network.

Recovery of the corticospinal tracts injured by subfalcine herniation: a diffusion tensor tractography study.

Recovery of the corticospinal tracts injured by subfalcine herniation: a diffusion tensor tractography study.

Ground-state fragmentation phase transition for attractive bosons in anisotropic traps

We construct a two-state theoretical model describing attractively interacting bosons in a cylindrical harmonic potential of varied anisotropy. These systems exhibit true many-body ground-state energy minima stable against variations in single-particle state radial and axial widths and occupation number. The many-body ground state undergoes a phase transition from pure to fragmented as the aspect ratio increases above an anisotropy threshold dependent on the interaction energy per particle. This fragmentation is robust and does not require careful tuning of experimental parameters.

Definition of Ktrans and FA Thresholds for Better Assessment of Experimental Glioma Using High-field MRI: A Feasibility Study

To define K(trans) and fractional anisotropy (FA) thresholds in correlation to histology for improved magnetic resonance imaging (MRI) tumor assessment in an animal model of brain glioma. Twelve rats underwent 4.7 T MRI at day 10 after tumor implantation. Anatomical scans (T2, T1 at 8 min after double dose contrast application) as well as dynamic contrast-enhanced (DCE) imaging with calculation of K(trans) and diffusion tensor imaging (DTI) with calculation of FA were performed. T2- and T1-derived tumor volumes were calculated and thresholds for K(trans) and FA were defined for best MRI tumor assessment correlated to histology. Tumor volumes were 159 ± 14 mm(3) (histology), 126 ± 26 mm(3) (T1 with contrast, r=0.76), and 153 ± 12 mm(3) (T2, r=0.84), respectively. K(trans)- and FA-derived tumor volumes were 160 ± 16 mm(3) (for K(trans ≥ 0.04 min(-1), r=0.94), and 159 ± 14 mm(3) (for FA £0.14, r=0.96), respectively. DCE-MRI and DTI with calculation of K(trans) and FA maps allow very precise brain glioma assessment comparable to histology if established thresholds for the given tumor model are used.

SELF-CONSISTENT ION CYCLOTRON ANISOTROPY-BETA RELATION FOR SOLAR WIND PROTONS

We derive a set of self-consistent marginally stable states for a system of ion-cyclotron waves propagating parallel to the large-scale magnetic field through a homogeneous proton-electron plasma. The proton distributions and the wave dispersions are related through the condition that no further ion-cyclotron resonant particle scattering or wave growth/damping may take place. The thermal anisotropy of the protons in these states therefore defines the threshold value for triggering the proton-cyclotron anisotropy instability. A number of recent papers have noted that the anisotropy of solar wind protons at 1 AU does not seem to be limited by the proton-cyclotron anisotropy threshold, even at low plasma beta. However, this puzzle seems to be due solely to the estimation of this anisotropy threshold under the assumption that the protons have a bi-Maxwellian distribution. We note that bi-Maxwellian distributions are never marginally stable to the resonant cyclotron interaction, so these estimates do not represent physically valid thresholds. The threshold anisotropies obtained from our marginally stable states are much larger, as a function of proton parallel beta, than the bi-Maxwellian estimates, and we show that the measured data remains below these more rigorous thresholds. Thus, the results of this paper resolve the apparent contradiction presented by the solar wind anisotropy observations at 1 AU: The bi-Maxwellian anisotropies are not rigorous thresholds, and so do not limit the proton distributions in the solar wind.

Quantitative analysis of fiber tractography in cervical spondylotic myelopathy

Background contextDiffusion tensor fiber tractography is an emerging tool for the visualization of spinal cord microstructure. However, there are few quantitative analyses of the damage in the nerve fiber tracts of the myelopathic spinal cord. PurposeThe aim of this study was to develop a quantitative approach for fiber tractography analysis in cervical spondylotic myelopathy (CSM). Study design/settingProspective study on a series of patients. Materials and methodsA total of 22 volunteers were recruited with informed consent, including 15 healthy subjects and 7 CSM patients. The clinical severity of CSM was evaluated using modified Japanese Orthopedic Association (JOA) score. The microstructure of myelopathic cervical cord was analyzed using diffusion tensor imaging. Diffusion tensor imaging was performed with a 3.0-T magnetic resonance imaging scanner using pulsed gradient, spin-echo, echo-planar imaging sequence. Fiber tractography was generated via TrackVis with fractional anisotropy threshold set at 0.2 and angle threshold at 40°. Region of interest (ROI) was defined to cover C4 level only or the whole-length cervical spinal cord from C1 to C7 for analysis. The length and density of tracked nerve bundles were measured for comparison between healthy subjects and CSM patients. ResultsThe length of tracked nerve bundles significantly shortened in CSM patients compared with healthy subjects (healthy: 6.85–77.90 mm, CSM: 0.68–62.53 mm). The density of the tracked nerve bundles was also lower in CSM patients (healthy: 086±0.03, CSM: 0.80±0.06, p<.05). Although the definition of ROI covering C4 only or whole cervical cord appeared not to affect the trend of the disparity between healthy and myelopathic cervical cords, the density of the tracked nerve bundle through whole myelopathic cords was in an association with the modified JOA score in CSM cases (r=0.949, p=.015), yet not found with ROI at C4 only (r=0.316, p=.684). ConclusionsThe quantitative analysis of fiber tractography is a reliable approach to detect cervical spondylotic myelopathic lesions compared with healthy spinal cords. It could be employed to delineate the severity of CSM.

Conditions for quantitative evaluation of injured spinal cord by in vivo diffusion tensor imaging and tractography: Preclinical longitudinal study in common marmosets

Conventional magnetic resonance imaging (MRI) can detect hemorrhage, edema, syrinx, and spinal cord atrophy, but not axonal disruption after spinal cord injury (SCI). We previously demonstrated that diffusion tensor tractography (DTT) could depict axonal disruption after hemisection SCI in common marmosets. In the present study, to determine the relationship between DTT results and functional recovery after contusive SCI, we performed longitudinal DTT, behavioral, and histological analyses before and after contusive SCI in common marmosets. By comparing the tract fiber estimate depicted by DTT with neuronal fibers labeled with RT97 and SMI-31, anti-neurofilament antibodies, we determined the optimal fractional anisotropy (FA) threshold for fiber tracking to be 0.40. The ratio of the number of tract fiber estimates at the lesion site to the number before SCI, determined by DTT, was significantly correlated with the functional recovery after SCI. Moreover, comparison of the longitudinal pre- and post-SCI FA and axial diffusivity (λ(‖)) values revealed that they decreased after injury at the sites caudal to the lesion epicenter in the corticospinal tract and rostral to the lesion epicenter in the dorsal column. The FA values, then, showed partial recovery in the dorsal column. FA-value-oriented color DTT was used to represent axonal sparing or regeneration of the different tracts. These findings indicated that DTT analysis might be a versatile non-invasive tool for evaluating the axonal disruption after SCI.

A new approach for corticospinal tract reconstruction based on navigated transcranial stimulation and standardized fractional anisotropy values

To establish a novel approach for fiber tracking based on navigated transcranial magnetic stimulation (nTMS) mapping of the primary motor cortex and to propose a new algorithm for determination of an individualized fractional anisotropy value for reliable and objective fiber tracking. 50 patients (22 females, 28 males, median age 58 years (20-80)) with brain tumors compromising the primary motor cortex and the corticospinal tract underwent preoperative MR imaging and nTMS mapping. Stimulation spots evoking muscle potentials (MEP) closest to the tumor were imported into the fiber tracking software and set as seed points for tractography. Next the individual FA threshold, i.e. the highest FA value leading to visualization of tracts at a predefined minimum fiber length of 110 mm, was determined. Fiber tracking was then performed at a fractional anisotropy value of 75% and 50% of the individual FA threshold. In addition, fiber tracking according to the conventional knowledge-based approach was performed. Results of tractography of either method were presented to the surgeon for preoperative planning and integrated into the navigation system and its impact was rated using a questionnaire. Mapping of the motor cortex was successful in all patients. A fractional anisotropy threshold for corticospinal tract reconstruction could be obtained in every case. TMS-based results changed or modified surgical strategy in 23 of 50 patients (46%), whereas knowledge-based results would have changed surgical strategy in 11 of 50 patients (22%). Tractography results facilitated intraoperative orientation and electrical stimulation in 28 of 50 (56%) patients. Tracking at 75% of the individual FA thresholds was considered most beneficial by the respective surgeons. Fiber tracking based on nTMS by the proposed standardized algorithm represents an objective visualization method based on functional data and provides a valuable instrument for preoperative planning and intraoperative orientation and monitoring.

Histological Validation of DW-MRI Tractography in Human Postmortem Tissue

Despite several previous attempts, histological validation of diffusion-weighted magnetic resonance imaging (DW-MRI)-based tractography as true axonal fiber pathways remains difficult. In the present study, we establish a method to compare histological and tractography data precisely enough for statements on the level of single tractography pathways. To this end, we used carbocyanine dyes to trace connections in human postmortem tissue and aligned them to high-resolution DW-MRI of the same tissue processed within the diffusion tensor imaging (DTI) formalism. We provide robust definitions of sensitivity (true positives) and specificity (true negatives) for DTI tractography and characterize tractography paths in terms of receiver operating characteristics. With sensitivity and specificity rates of approximately 80%, we could show a clear correspondence between histological and inferred tracts. Furthermore, we investigated the effect of fractional anisotropy (FA) thresholds for the tractography and identified FA values between 0.02 and 0.08 as optimal in our study. Last, we validated the course of entire tractography curves to move beyond correctness determination based on pairs of single points on a tract. Thus, histological techniques, in conjunction with alignment and processing tools, may serve as an important validation method of DW-MRI on the level of inferred tractography projections between brain areas.

Three-Dimensional Interactive and Stereotactic Human Brain Atlas of White Matter Tracts

We present a human brain atlas of white matter (WM) tracts containing 40 major tracts, which is three-dimensional (3D), segmented, labeled, interactive, stereotactic and correlated to structure and vasculature. We consider: (1) WM accuracy by correlating WM tracts to underlying neuroanatomy and quantifying them; (2) balance between realism and completeness by processing a sequence of track volumes generated for various parameters with the increasing track number to enable a tract "shape convergence". MPRAGE and DTI in 64 directions of the same subject were acquired on 3 Tesla. The method has three steps: DTI-MPRAGE registration, 3D tract generation from DTI, to WM reconstruction from MPRAGE to parcellation into 17 components. 82 track volumes were generated for a wide spectrum of parameter values: Fractional Anisotropy threshold in [0.0125, 0.55] and trajectory angle lower than 45°, 60°, 65°, 70°, 75°, 80°, 85°, 90°. For each tract, a sequence of track volumes was processed to create/edit contours delineating this tract to achieve its shape convergence. The parcellated tracts were grouped into commissures, associations, projections and posterior fossa tracts, and labeled following Terminologia Anatomica. To facilitate that, a dedicated tract editor is developed which processes multiple track volumes, handles tracts in three representations (tracks, contours, envelopes); provides editing/visualization simultaneously on axial, coronal, sagittal planes; enables tract labeling and coloring; and provides numerous tools (track counting, smoothing and length thresholding; representation conversion and saving; structural atlas support). A stereotactic tract atlas along with parcellated WM was developed to explore in real-time any individual tract or their groups along with surrounding neuroanatomy.

Caveats in diffusion tensor imaging interpretation

Diffusion tensor imaging (DTI) utilizes the diffusion of water to create detailed maps of brain white matter structure. DTI provides information not apparent on conventional magnetic resonance imaging, and has proved to be more sensitive to disruption of white matter development than any other imaging method. In children with cerebral palsy, DTI can add anatomical specificity and quantitative information about the white matter tract size and microstructure. It has been of great benefit in children born preterm with periventricular leukomalacia (PVL).1 Studies have variably shown correlations between corticospinal tract injury2 and thalamocortical projections (posterior thalamic radiation)3,4 in the pathophysiology of motor disability in these children. Yoshida et al.5 reported that when compared with controls, children with PVL have reduced fractional anisotropy and number of fibers in the region of corticospinal tract injury and posterior thalamic radiation, and that these measurements correlate with a clinical measure of function. These findings are a quantitative confirmation of the qualitative data from previous studies and from the visual impression of experienced clinicians. This categorization of variable injury in sensory and motor pathways provides further support for the development of rehabilitative interventions that selectively target affected pathways. The interpretation of results from DTI studies is predicated on an understanding of the strengths and limitations of the methodology employed. The study by Yoshida et al. illustrates important questions regarding the interpretation of quantitative DTI data and the limitations of analysing individual tracts in disorders affecting multiple brain regions such as in children with PVL.6 In regard to interpretation of DTI data, three points need to be carefully considered. First, brain volume and diffusivity have a strong time-dependence, particularly in the first 2 years of life; therefore, studies involving participants in their infancy and childhood may be influenced by this age effect. Second, measurements based on regions of interest are largely evaluator-dependent and interrater agreement should always be presented, as it is an important indicator of the reliability and reproducibility of the results. Finally, measures of imaging contrast and volume are interrelated, as the fractional anisotropy threshold setting will partially determine the volume calculated and when regions of interest are generated, the volume will influence the fractional anisotropy measurements. This type of coupling of the ‘anatomical definition’ and ‘intensity shift’ is a common issue in image analysis and requires careful interpretation. DTI tractography will only describe specific tracts. As the injury in children born preterm is varied and diffuse to both gray and white matter, a global and integrative analysis of neuroanatomy is essential for understanding the pathophysiology of PVL. Recently, state-of-the-art non-linear normalization techniques, such as large-deformation diffeomorphic metric mapping, have been developed to obtain global and automated analysis of the whole brain.7 When combined with other imaging methods, such as functional resting connectivity,8 these tools have the potential to describe the pathophysiology of brain injury in children with cerebral palsy and other childhood neurological disorders accurately and automatically. This is an essential step for detailed anatomy function correlation studies and to provide crucial information that can be useful in intervention studies and for the determination of prognosis.

A role of diffusion tensor imaging in movement disorder surgery

The safe and reversible nature of deep brain stimulation (DBS) has allowed movement disorder neurosurgery to become commonplace throughout the world. Fundamental understanding of individual patient’s anatomy is critical for optimizing the effects and side effects of DBS surgery. Three patients undergoing stereotactic surgery for movement disorders, at the institution’s intraoperative magnetic resonance imaging operating suite, were studied with fiber tractography. Stereotactic targets and fiber tractography were determined on preoperative magnetic resonance imagings using the Schaltenbrand–Wahren atlas for definition in the BrainLab iPlan software (BrainLAB Inc., Feldkirchen, Germany). Subthalamic nucleus, globus pallidus interna, and ventral intermediate nucleus targets were studied. Diffusion tensor imaging parameters used ranged from 2 to 8 mm for volume of interest in the x/y/z planes, fiber length was kept constant at 30 mm, and fractional anisotropy threshold varied from 0.20 to 0.45. Diffusion tensor imaging tractography allowed reliable and reproducible visualization and correlation between frontal eye field, premotor, primary motor, and primary sensory cortices via corticospinal tracts and corticopontocerebellar tracts. There is an apparent increase in the number of cortical regions targeted by the fiber tracts as the region of interest is enlarged. This represents a possible mechanism of the increased effects and side effects observed with higher stimulation voltages. Currently available diffusion tensor imaging techniques allow potential methods to characterize the effects and side effects of DBS. This technology has the potential of being a powerful tool to optimize DBS neurosurgery.

Effect of sorbic acid doping on flux pinning in bulk MgB2 with the percolation model

In this paper, we study the doping effect of sorbic acid (C6H8O2), from 0 to 20wt.% of the total MgB2, on critical temperature (Tc), critical current density (Jc), irreversibility field (Hirr) and crystalline structure. The XRD patterns of samples show a slightly decrease in a-axis lattice parameter for doped samples, due to the partial substitution of carbon at boron site. On the other hand, we investigate the influence of doping on the behavior of flux pinning and Jc(B) in the framework of percolation theory and it is found that the Jc(B) behavior could be well fitted in high field region. The two key parameters, anisotropy and percolation threshold, play very important roles. It is believed that the enhancement of Jc is due to the reduction of anisotropy in high field region.

Magnetic Fluctuation Power Near Proton Temperature Anisotropy Instability Thresholds in the Solar Wind

The proton temperature anisotropy in the solar wind is known to be constrained by the theoretical thresholds for pressure-anisotropy-driven instabilities. Here, we use approximately 1x10;{6} independent measurements of gyroscale magnetic fluctuations in the solar wind to show for the first time that these fluctuations are enhanced along the temperature anisotropy thresholds of the mirror, proton oblique firehose, and ion cyclotron instabilities. In addition, the measured magnetic compressibility is enhanced at high plasma beta (beta_{ parallel} greater, similar1) along the mirror instability threshold but small elsewhere, consistent with expectations of the mirror mode. We also show that the short wavelength magnetic fluctuation power is a strong function of collisionality, which relaxes the temperature anisotropy away from the instability conditions and reduces correspondingly the fluctuation power.

Diffusion Tensor Imaging Study of the Cortical Origin and Course of the Corticospinal Tract in Healthy Children

Several studies have questioned the traditional belief that the corticospinal tract (CST) arises exclusively from the precentral gyrus and passes through the anterior half of the posterior limb of the internal capsule (PLIC) in humans; however, no direct evidence existed from structural imaging, and developmental aspects of CST origin have not been clarified. We used diffusion tensor imaging (DTI) tractography to test the hypotheses that CST can originate from both pre- and postcentral gyri and is located posteriorly in the PLIC, and we also determined how age, sex, or handedness affected these locations. Forty-two healthy children (2.6-17.5 years of age; 20 girls) underwent DTI. Subsequently, tractography was performed on the basis of fiber assignment by continuous tracking (FACT) algorithm and brute force approach, with a fractional anisotropy (FA) threshold of <0.2 and an angle threshold of >50 degrees . The CST was isolated by using a knowledge-based region-of-interest approach, and its cortical origin and location on the PLIC was determined. DTI revealed that the CST originated from both pre- and postcentral gyri in 71.4% of hemispheres, from the precentral gyrus only in 19%, and from the postcentral gyrus only in 7.1%. The overall distribution was similar in both hemispheres. However, children with CST originating from both pre- and postcentral gyri were older (mean, 11.1 years of age) than those with precentral origin (mean, 5.8 years of age) or postcentral origin (mean, 7.8 years of age) only (P = .00003). The center of the CST was localized at 65% of the length (from its anterior margin) of the PLIC, and the CST occupied 26.5% of its anteroposterior length. There was a significant positive correlation between age and FA of the CST (r = 0.49; P = .002). The volume of the precentral portion of the left CST was significantly higher than that of its postcentral portion (P = .01) and that of the right CST (P = .0002). The pattern of cortical origin of CST, its location at the level of PLIC, and its volume and FA were unaffected by sex or handedness. The CST most frequently originates from both pre- and postcentral gyri, especially in older children, and is typically centered approximately two thirds of the distance from the anterior margin of the PLIC and occupies about a quarter of its anteroposterior length. In young children, the CST can often be seen originating exclusively from the precentral gyrus by DTI.

Limits for the Firehose Instability in Space Plasmas

Electromagnetic instabilities in high-β plasmas, where β is the ratio of the kinetic plasma energy to the magnetic energy, have a broad range of astrophysical applications. The presence of temperature anisotropies T ∥ /T ⊥ >1 (where ∥ and ⊥ denote directions relative to the background magnetic field) in solar flares and the solar wind is sustained by the observations and robust acceleration mechanisms that heat plasma particles in the parallel direction. The surplus of parallel kinetic energy can excite either the Weibel-like instability (WI) of the ordinary mode perpendicular to the magnetic field or the firehose instability (FHI) of the circularly polarized waves at parallel propagation. The interplay of these two instabilities is examined. The growth rates and the thresholds provided by the kinetic Vlasov – Maxwell theory are compared. The WI is the fastest growing one with a growth rate that is several orders of magnitude larger than that of the FHI. These instabilities are however inhibited by the ambient magnetic field by introducing a temperature anisotropy threshold. The WI admits a larger anisotropy threshold, so that, under this threshold, the FHI remains the principal mechanism of relaxation. The criteria provided here by describing the interplay of the WI and FHI are relevant for the existence of these two instabilities in any space plasma system characterized by an excess of parallel kinetic energy.

Semiautomatic tractography: motor pathway segmentation in patients with intracranial vascular malformations

Object The visualization of white matter tracts using tractography has previously been achieved by displaying streamlines that pass between regions of interest (ROIs). These techniques require a significant amount of user interaction, and their results are entirely dependent on the positioning of the ROIs. Furthermore, in patients with intracerebral hemorrhage secondary to intracranial vascular malformation, there is often significant cerebral edema and susceptibility artifact from the hematoma, which degrade the reliability of tractography. In this paper, the authors' objectives were to visualize the motor pathways of patients with hemorrhagic and nonhemorrhagic vascular malformations by using a novel semiautomated technique that functions without the need for multiple ROIs. Methods The authors investigated the tractography appearance of the descending motor pathways in 6 patients with intracranial vascular malformations. Of these patients 4 presented with a spontaneous intracranial hemorrhage, 2 of whom were clinically hemiparetic. Diffusion tensor imaging was performed using a 1.5-T clinical MR imaging system, and whole-brain tractography was performed after reconstruction of the data. A fractional anisotropy threshold of 0.05 was used to terminate the tractography. The semiautomatic motor pathway segmentation technique required definition of a single voxel within the corticospinal tract of the medulla from which the descending motor pathways were automatically defined by grouping together all streamlines within the entire image with a geometry similar to that of the single streamline generated from this initial voxel. The results of this segmentation were then visually assessed and compared with the patient's motor function. Results The authors' semiautomatic algorithm consistently visualized the location of the descending motor pathways in patients with nonhemorrhagic and hemorrhagic vascular malformations. In 1 patient whose complete right hemiplegia (complete paralysis) was caused by a large left frontal hematoma that bisected the descending motor pathways, the authors were unable to reconstruct the motor pathways due to severe tract degeneration. However, in all cases in which motor function was intact or only mildly impaired, the technique clearly delineated the motor pathways, even in the presence of large anatomical displacement by the vascular abnormality or associated hemorrhage. Conclusions Semiautomatic tractography allows consistent and rapid demonstration of the descending motor pathways in patients with hemorrhagic and nonhemorrhagic intracranial vascular malformations. The technique allows the use of a comparatively low fractional anisotropy threshold and does not require the definition of multiple ROIs. These techniques may help to improve the clinical feasibility and potentially the reliability of tractography for the evaluation of patients with intracranial vascular malformations as well as other space-occupying lesions of the brain.

Fractional Anisotropy–Threshold Dependence in Tract-Based Diffusion Tensor Analysis: Evaluation of the Uncinate Fasciculus in Alzheimer Disease

Tract-based analysis can be used to investigate required tracts extracted from other fiber tracts. However, the fractional anisotropy (FA) threshold influences tractography analysis. The current study evaluated the influence of the FA threshold in measuring diffusion tensor parameters for tract-based analysis of the uncinate fasciculus in subjects with Alzheimer disease (AD). Subjects included 30 patients with AD and 10 healthy controls. We acquired tractographies of the uncinate fasciculus by using different FA thresholds. We measured mean FA and the apparent diffusion coefficient (ADC) along the uncinate fasciculus for different FA thresholds and evaluated the correlation between diffusion tensor parameters (FA, ADC) and the Mini-Mental State Examination (MMSE) scores. The uncinate fasciculus showed lower mean FA and higher mean ADC values in cases with more severe AD. A higher FA threshold led to a lower mean ADC value and a higher mean FA value along the uncinate fasciculus, whereas the relative order of measured values according to the severity of AD was not influenced by the FA threshold. An FA threshold of 0.2 showed higher correlation between mean ADC values and MMSE scores. FA thresholds of 0.15 and 0.20 showed higher correlation between mean FA values and MMSE scores. Appropriate selection of the FA threshold leads to higher correlation between diffusion tensor parameters and the severity of AD. For tract-based analysis of degenerative diseases such as AD, appropriate selection of the FA threshold for tractography is important.