Fibre integrity and diffusivity of the pyramidal tract and motor cortex within and adjacent to brain tumour in patients with or without neurological deficits.

BACKGROUND Assessment of the relationship between preoperative neurological deficits and diffusion tensor imaging (DTI) parameters in patients with brain tumour within/adjacent to pyramidal tract and motor cortex. Evaluation of the difference in fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values in patients with low and high grade gliomas. MATERIAL AND METHODS 20 patients with supratentorial brain tumours were divided into two groups: I with preoperative neurological deficits and II without preoperative neurological deficits. 8/20 tumours were classified as low grade gliomas, 10/20 as high grade gliomas and 2/10 as metastases. All MR examinations were performed on a 3T scanner. FA and ADC values were calculated for a precentral gyrus (PCG), a posterior limb of the internal capsule (PLIC) and a pyramidal tract (PT) ipsilateral and contralateral to the tumour side. These values were compared between patients with and without preoperative neurological deficits, with low and high grade gliomas. RESULTS A statistical analysis revealed significant differences between patients with and without preoperative neurological deficits in PCGs and PTs ipsilateral to the tumour side. Separate analysis conducted in the group with preoperative neurological deficits showed significant statistical differences only in terms of FA values comparing ipsilateral and contralateral tumour side. No statistically significant difference was observed comparing FA and ADC values ipsilateral and contralateral to the tumour side in the group without preoperative neurological deficits and between patients with low and high grade gliomas. CONCLUSIONS There is a relation between FA and ADC values and preoperative deficits in patients with brain tumour adjacent/within the main white matter tracts. Tumour relation to the white matter tracts is more important than the glioma WHO grade.