Article,

Diffusion tensor MR imaging of the brain and white matter tractography.

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AJR American Journal of Roentgenology, 178 (1): 3--16 (January 2002)

Abstract

In the last 10-15 years, MR imaging techniques have been increasingly applied to the study of molecular displacement (diffusion) in biologic tissue. The ability to spatially map the diffusion of free water protons in vivo using 1H MR imaging and the observation that the diffusion of free water protons is reduced in acutely infarcted brain tissue are responsible for the widespread use of these techniques in clinical imaging. More recently, the dependency of molecular diffusion on the orientation of white matter fiber tracts has elicited great interest in studying the factors that influence this dependency and in spatially mapping these fiber tracts using diffusion imaging. In this paper, we briefly describe the tensor theory used to characterize molecular diffusion in white matter and how the tensor elements are measured experimentally using diffusion-sensitive MR imaging. We then review techniques for acquiring relatively high-resolution diffusion-sensitive MR images and computer-based algorithms that allow the generation of white matter fiber tract maps from the tensor data. We provide an overview of current experience and some clinical examples that are ongoing in our center. Finally, we discuss the possible future role of these white matter maps in the assessment of white matter diseases, congenital brain malformations, central nervous system neoplasms (presurgical evaluation), and brain function.

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