Visual Pathway Study Using in vivo DTI Tractography to Complement Classical Anatomy

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

OBJECTIVE: To use DTI tractography to study the OR and Meyer’s loop (ML) anatomy in vivo.

METHODS: Ten healthy subjects underwent magnetic resonance imaging with diffusion imaging at 3T. Using a fiducial-based DTI tractography tool (Slicer 3.3), seeds were placed near the lateral geniculate nucleus (LGN) to reconstruct individual visual pathways and neighboring tracts. Projections of the optic radiations onto 3D brain models were shown individually in order 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+/-3.8mm and 40.6+/-5.7 mm, respectively.

CONCLUSION: DTI tractography provides a practical complementary method to study the OR and ML anatomy in vivo, and with reference to individual 3D brain anatomy.

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