Diffusion tensor tractography for the surgical management of XXXX .

@entity1 @entity808 @entity227 @entity1263 @entity5
OBJECT @entity1263 ( @entity1263 ) are uncommon but bear a significant risk of @entity5 . High-resolution MRI is the standard technique for characterizing @entity1263 . However, planning the appropriate extent of resection and subsequent reconstructive strategies is highly dependent on the intraoperative findings because preoperative MRI evaluation can be insufficient. Diffusion tensor tractography (DTT) represents a recently developed advanced MRI technique that reveals the microstructure of tissues based on monitoring the random movement of water molecules. DTT has the potential to provide diagnostic insights beyond conventional MRI techniques due to its mapping of specific fibrillar nerve structures. Here, DTT was applied to evaluate @entity1263 and to examine the usefulness of this method for the correct delineation of @entity5 and healthy nerve tissue and the value of this information in the preoperative planning of surgical interventions. METHODS In this prospective study, @entity1 with the clinical symptoms of a PNST were investigated using DTT 3-Tesla MRI scans. Image data processing and tractography were performed using the FACT (fiber assessment by continuous tracking) algorithm and multiple-regions-of-interest approach. The surgical findings were then compared with the results of the DTT MRI scans. @entity227 and the correlation with the intraoperative findings were graded. RESULTS In a 21-month period, 12 @entity1 with @entity1263 were investigated (7 female and 5 male @entity1 with a mean age of 46.2    19.2 years). All @entity1 underwent surgical @entity5 . @entity808 was the most common benign histopathological finding (n = 7), whereas 2 malignant lesions were detected. In 10 of 12 @entity1 , good preoperative nerve fascicle visualization was achieved using DTT scans. In 9 of 10 @entity1 with good preoperative fascicle visualization, good intraoperative correlation between the DTT scans and surgical anatomy was found. CONCLUSIONS DTT properly visualizes the peripheral nerve fascicles and their correct anatomical relation to PNST. DTT represents a promising new method for the preinterventional planning of nerve @entity5 resection.
