Multitensor Tractography Enables Better Depiction of Motor Pathways: Initial Clinical Experience Using Diffusion-Weighted MR Imaging with Standard b-Value

The relative number of points constituting each fiber bundle in the contralesional hemisphere are shown. For example, by using tensor-based tractography, case 1 had mostly trunk fibers depicted (97%) and a low percentage (3%) of LE fibers. On the other hand, by using the multitensor technique, the fibers from other parts are also depicted, and, in this particular case, the trunk fibers constitute only 23% of all fibers. Of note, in general the multitensor approach is able to depict fibers from various locations, whereas the single-tensor approach is limited to the depiction of the trunk and hand regions.

The relative number of points constituting each fiber bundle in the lesional hemisphere is shown. Of note, the depiction of the fibers in this hemisphere is largely limited to the trunk fibers when the single-tensor approach is used. The difference between the single-tensor technique and the multitensor technique becomes obvious in the lesional hemisphere.

A 55-year-old man (case 4) presented to the hospital with a Jacksonian seizure starting in his right fingers. On MR imaging, a large left frontal lobe tumor was depicted. Of note, the multitensor technique is able to depict fibers from various locations and is able to reveal the relationship between the vital fiber tracts and the dorsal edge of the tumor. On the transaxial view, note that single-tensor tractography is able to show that the trunk fibers (purple) are located within the tumor. Using the multitensor approach, one can see that the hand fibers (green) are involved. Facial fibers (blue) are also seen in close proximity to the tumor.