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Visual Pathway Study Using In Vivo Diffusion Tensor Imaging Tractography to Complement Classic Anatomy

Wu, Wentao MD, PhD*,§,‖; Rigolo, Laura MA*; O'Donnell, Lauren J. PhD; Norton, Isaiah BS*; Shriver, Sargent BS*; Golby, Alexandra J. MD*,‡

doi: 10.1227/NEU.0b013e31822efcae
Surgical Anatomy and Technique

BACKGROUND: Knowledge of the individual course of the optic radiations (ORs) is important to avoid postoperative visual deficits. Cadaveric studies of the visual pathways are limited because it has not been possible to separate the OR from neighboring tracts accurately and results may not apply to individual patients. Diffusion tensor imaging studies may be able to demonstrate the relationships between the OR and neighboring fibers in vivo in individual subjects.

OBJECTIVE: To use diffusion tensor imaging tractography to study the OR and the Meyer loop (ML) anatomy in vivo.

METHODS: Ten healthy subjects underwent magnetic resonance imaging with diffusion imaging at 3 T. With the use of a fiducial-based diffusion tensor imaging tractography tool (Slicer 3.3), seeds were placed near the lateral geniculate nucleus to reconstruct individual visual pathways and neighboring tracts. Projections of the ORs onto 3-dimensional brain models were shown individually to quantify relationships to key landmarks.

RESULTS: Two patterns of visual pathways were found. The OR ran more commonly deep in the whole superior and middle temporal gyri and superior temporal sulcus. The OR was closely surrounded in all cases by an inferior longitudinal fascicle and a parieto/occipito/temporo-pontine fascicle. The mean left and right distances between the tip of the OR and temporal pole were 39.8 ± 3.8 and 40.6 ± 5.7 mm, respectively.

CONCLUSION: Diffusion tensor imaging tractography provides a practical complementary method to study the OR and the Meyer loop anatomy in vivo with reference to individual 3-dimensional brain anatomy.

Brigham and Women's Hospital, Departments of *Neurosurgery and

Radiology, Harvard Medical School, Boston, Massachusetts

USA West China Hospital, Departments of §Radiology and

Neurosurgery, Sichuan University, Chengdu, Sichuan, China

Correspondence: Alexandra J. Golby, MD, Department of Neurosurgery, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115. E-mail:

Received September 7, 2010

Accepted March 25, 2011

Copyright © by the Congress of Neurological Surgeons