Quantitative characterization of the corticospinal tract at 3T.

BACKGROUND AND PURPOSE White matter tract-specific imaging will probably become a major component of clinical neuroradiology. Fiber tracking with diffusion tensor imaging (DTI) is widely used, but variability is substantial. This article reports the ranges of MR imaging appearance and right-left asymmetry of healthy corticospinal tracts (CST) reconstructed with DTI. METHODS For 20 healthy volunteers, whole-brain DTI data were coregistered with maps of absolute T1 and T2 relaxation times and magnetization transfer ratio (MTR), all acquired at 3T. For each individual, the 2 reconstructed CSTs and their asymmetry were analyzed with respect to the number of fibers reconstructed; tract volume; and individual MR imaging parameters restricted to the tracts. Interscan variability was estimated by repeat imaging of 8 individuals. RESULTS Reconstructed fiber number and tract volume are highly variable, rendering them insensitive to abnormalities in disease. Individual tract-restricted MR imaging parameters are more constrained, and their population averages and normal ranges are reported. The average population asymmetry is generally zero; therefore, normal ranges for an index of asymmetry are reported. By way of example, CST-restricted MR imaging parameters and their asymmetries are shown to be abnormal in an individual with multiple sclerosis who had a lesion affecting the CST. CONCLUSIONS The results constitute a normative dataset for the following imaging parameters of the CST: T1, T2, MTR, fractional anisotropy, mean diffusivity, transverse diffusivity, and the 3 diffusion tensor eigenvalues. These data can be used to identify, characterize, and establish the significance of changes in diseases that affect the CST.