Effect of DTT in neurosurgical planning of deep brain gliomas adjacent to corticospinal tract

Objective To investigate the effect of diffusion tensor fiber tracking (DTT) in evaluating the state of corticospinal tract adjacent to brain gliomas and the guidance for neurosurgical planning. Methods A total of 34 patients confirmed gliomas in the deep brain adjacent to corticospinal tract were randomly divided into trial group (16 cases) and control group (18 cases) from August 2006 to September 2008. The states of ipsilateral corticospinal tract were evaluated including displacement,infiltration or disruption. Regular MRI and fiber status of corticospinal tracts were used in combination to determine the appropriate surgical therapy in trial group. The lesion resection of the control group was only assisted by conventional MRI. The ratios of complete resection and postoperative morbidity were compared between trial group and control group.Results Of the 16 trial patients,the tumors were completely resected in 12 patients and partially resected in 4 patients including 1 patient with postoperative aggravation of neurological function. In 18 patients of control group,the tumors were completely resected in 11 patients and partially resected in 7 patients including 7 patients with new neurological deficit or postoperative aggravation of neurological function. The ratio of complete resection of trial group was higher than that of control group (P0.05). The statistical analysis also showed the ratio of postoperative morbidity in trial group was significantly lower than that of control group (P0.01). Conclusion DTT can provide additional information about corticospinal tracts and their relationship to the tumor. It is helpful to design a reasonable surgical plan for preserving vital tracts while maximizing the tumor resection.