| Part One:Quantitative Measurement of Corticospinal Tracts by MR Fiber Tractography:a reproducibility StudyObjective:To study the reproducibility of the quantitative measurement of number of white matter fiber bundles with Fiber Tractography,and to discuss the clinical reliability of the measurement.Materials and Methods:21 healthy volunteers received magnetic resonance diffusion tensor imaging(DTI) with GE 1.5T nuclear magnetic resunance system.The corticospinal tract was used for this study with Volume-One1.64 and diffusion Tensor Visualizer(dTV) software from Tokyo University for three-dimensional reconstruction of white matter fiber bundles.The software calculates the number of corticospinal tract (CST) as quantitative indicator.The measurement was repeated by a rater three times at different time and by three different raters at the same time.The measurement results were analyzed and the correlation coefficients were evaluated to represent reproducibility.After that,the same rater measures fractional anisotropy(FA) values of both sides of CST,and to study the significant difference of number and FA values of both sides of CST.Results:The range of the correlation coefficients(r value) by the same rater at three different time is from 0.737 to 0.939,and the conterpart is from 0.062 to 0.727;it can be concluded that the correlation coefficient by the same rater is higher than that by three different raters.There is no significant difference about the number and the FA values by the same rater.Conclusion:The reproducibility of measuring the number of tractography by the same rater is higher than that by different raters.The reproducibility is good if the measurement is by the same proficient rater.Part Two:Feasibility Study of Quantitative Assessment of Diffusion Tensor Tractography in Evaluating the Damage of Corticospinal Tract in Acute Intracerebral Hemorrhage. Objective:To investigate the feasibility of quantitative assessment of diffusion tensor tractography(DTI) in evaluating the damage of corticospinal tract(CST) in acute Intracerebral Hemorrhage(ICH).Materials and Methods:thirty-two patients were enrolled for this study.DTT was obtained in early stage of ICH.The CST was reconstructed with Volume-One1.64 and diffusion Tensor Visualizer(dTV) software from Tokyo University.To observe the condition of the affected side of CST:the compression,the displacement or the destruction,and the relative remaining number of the CST,which is as quantitative indicator,was calculated.Results:the compression,the displacement and the destruction of the CST were observed in DTT images of those patients.The correlation coefficient(r value) between relative remaining number of the CST and score of Fugl-Meyer after the onset of ICH is 0.757(P<0.01).Conclusion:The structure of CST and its profile changes could be observed clearly from different angles with DTT images.DTT can quantitatively evaluate the state of injury of CST in acute ICH.Part Three:quantitative evaluation of diffusion tensor tractography:correlation of corticospinal tract injury and the outcome of motor function after three month of Intracerebral hemorrhage.Objective:To investigate the predicting value of DTT by analyzing CST injury to the motor function after Intracerebral hemorrhage with quantitative DTT.Materials and Methods:Diffusion tensor imaging was performed in twenty-five acute Intracerebral hemorrhage patients,whose hemorrhage involves basal ganglia, internal capsule or corona radiate.The affected side of CST was reconstructed with Volume-One1.64 and diffusion Tensor Visualizerâ…¡(dTVâ…¡) software from Tokyo University.The relative remaining number of CST,which is as quantitative indicator, was calculated.Fugl-Meyer scoring was used to evaluate the prognosis.Results:The correlation coefficient(r value) between relative remaining number of CST and Fugl-Meyer score after three month of ICH is 0.879(P<0.01). Conclusion:Quantitative DTT of CST could be used to predict the motor function in ICH patients.
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