Visualization of Brain White Matter Tracts Using Heavily T2-weighted Three-dimensional Fluid-attenuated Inversion-recovery Magnetic Resonance Imaging

The purpose of this study was to elucidate which white matter (WM)-tracts are visualized on heavily T2-weighted three-dimensional fluid-attenuated inversion-recovery (hT2w-3D-FLAIR) images. Records of seven patients who underwent hT2w-3D-FLAIR and diffusion tensor imaging (DTI) of the head at 3 Tesla were analyzed. Two neuroradiologists determined WM-tracts visualized on hT2w-3D-FLAIR and identified anatomical points through which they ran. A third neuroradiologist determined the WM-tracts running through those points on DTI. Correspondence between hT2w-3D-FLAIR and DTI WM-tracts was used to confirm technique validity. As a result, the corticospinal tract (CST), medial lemniscus (ML), and superior cerebellar peduncle (SCP) were visualized as high intensity on hT2w-3D-FLAIR and ran through the following points: CST, 20 mm lateral from the lateral margin of the third ventricle at the thalamic level; ML, 6 mm anterior to the anterior margin of the fourth ventricle at the trigeminal nerve level; and SCP, just lateral to the fourth ventricle at the trigeminal nerve level. The third neuroradiologist determined that the WM-tracts ran through those points on DTI in all patients. Consequently, WM-tracts determined on hT2w-3D-FLAIR and DTI completely corresponded. In conclusion, the CST, ML, and SCP were visualized as high intensity on hT2w-3D-FLAIR. This technique is a potentially supplemental DTI neurographic modality.