A Fiber Dissection Study of the Anterior Commissure: Correlations with Diffusion Spectrum Imaging Tractography and Clinical Relevance in Gliomas
A Fiber Dissection Study of the Anterior Commissure: Correlations with Diffusion Spectrum Imaging Tractography and Clinical Relevance in Gliomas
复制标题
DOI：
10.1007/s10548-021-00879-5
复制
发表时间：
2021-11-09
期刊：
影响因子：
2.7
通讯作者：
Nakada, Mitsutoshi
中科院分区：
文献类型：
--
作者：
Liu, Xiaoliang;Kinoshita, Masashi;Nakada, Mitsutoshi
前连合连接双侧颞叶和嗅觉区，其结构和功能在许多方面仍不清楚。通过尸体纤维解剖（FD）和扩散光谱成像（DSI）比较描述前连合的解剖细节，从而完善我们对该通道的认识，并探讨其在胶质瘤迁移中的临床意义。12个正常的死后半球与Klingler的方法进行处理，并进行FD与内侧，下方和外侧的途径。FD结果与DSI纤维束成像结果相关。为了说明临床相关性，两例复发性颞部高级别胶质瘤的描述。我们的FD和DSI纤维束成像的前连合揭示了一个新的解剖范例。FD证实，前肢（有时缺席和变量）和外侧/颞部的延伸，包括喙部和尾侧部分，分别前连合纤维。外侧/颞侧延伸的形状主要类似于“H”。DSI纤维束成像结果与FD结果一致。根据FD，Virchow-Robin间隙与蛛网膜下腔连续，非常靠近前连合。这两个临床病例表现出严重的意识和行为障碍，尽管局部肿瘤控制良好。随后的磁共振图像显示新的病变浸润对侧颞叶。FD结合DSI提供了解剖细节，有助于更好地了解前连合。胶质瘤迁移至对侧颞叶的路径包括前连合、Virchow-Robin间隙和蛛网膜下腔，具有临床相关性。
The anterior commissure, which connects bilateral temporal lobes and olfactive areas, remains elusive in many aspects of its structure and functional role. To comparatively describe anatomical details of the anterior commissure using cadaveric fiber dissection (FD) and diffusion spectrum imaging (DSI) thus refining our knowledge of the tract and exploring its clinical relevance in glioma migration. Twelve normal postmortem hemispheres were treated with Klingler's method and subjected to FD with medial, inferior, and lateral approaches. The FD findings were correlated with DSI tractography results. To illustrate the clinical relevance, two patients with recurrent temporal high-grade glioma are described. Our FD and DSI tractography of the anterior commissure disclosed a new anatomical paradigm. The FD confirmed that the anterior limb (absent sometimes and variable) and the lateral/temporal extension include the rostral portion and caudal portion, respectively, of the anterior commissure fibers. The shape of the lateral/temporal extension predominantly resembles an 'H'. The DSI tractography findings corresponded to these FD results. According to the FD, the Virchow-Robin space is continuous with the subarachnoid space and very close to the anterior commissure. The two clinical cases presented severe disturbances of consciousness and behavior despite good local tumor control. Subsequent magnetic resonance images showed new lesions infiltrating the contralateral temporal lobes. FD combined with DSI provided anatomical details facilitating a better understanding of the anterior commissure. Glioma migration routes to the contralateral temporal lobe included the anterior commissure, Virchow-Robin space, and subarachnoid space and were clinically relevant.