Corticospinal tracts by diffusion tensor tractography in patients with arteriovenous malformations

Objective: To visualize the corticospinal tract (CST) in patients with arteriovenous malformations (AVMs) by using diffusion tensor tractography (DTT) and to confirm the clinical reliability of DTT in patients with AVMs. Methods: We performed DTT in 24 patients who had their AVMs near the CST. Tracts and AVMs were shown simultaneously, providing information on their spatial relationships. We also counted numbers of voxels in the DTT-CST at the level of the AVM. Results: DTT was visualized in 23 patients. In all 9 patients with hemiparesis, their DTT-CSTs were involved in the AVM or its surrounding lesion. Their volume of DTT-CST at the affected side was significantly decreased when compared with the contralateral side (P= 0.0469). All 14 patients whose DTT-CSTs were free from lesion had no hemiparesis. Conclusions: DTT was safe and clinically applicable in patients with AVMs. DTT is recommended when an AVM is located near the corticospinal tract.