Introduction: The cerebral tracts may be displaced, invaded or destroyed by intrinsic tumor growth. Postoperative neurological deficits may arise de novo or worsen if uninvolved tracts are injured. MRI tractography is a novel technique applied to visualize the distribution of the nearby tracts and surgical strategy. The condition and the location of the tract may determine the radicality and the trajectory of surgery.
Objective: To evaluate the value of tractography in preoperative decision making during surgery of deep brain lesions
Methods: MRI tractography was performed in 30 patients with intrinsic brain lesions. The condition and the location of the tracts, and their influence on surgical decision were studied. Two surgeons have separately decided on the best approach for surgery of brain tumors with and without availability of tractography data. Changing the decision was recorded and correlated to the tractography data.
Results: MRI tractography was a highly influencing study in decision making before embarking on surgery for deep brain lesions related to important recordable brain tracts.
Conclusions: MRI tractography helps in determining the site of the cortical incision and the trajectory to access deeply seated brain lesions. In the same time, it has significant impact on the decision between radicality and conservatism in many cases.
Patient Care: The attendees will be able to chose the safest appraoch for patients with brain lesions applying knowledge of MRI tractography
Learning Objectives: The attenddees will be able modefing the surgical trajectory after reviwing MRI tractography data in deep or superficial brain lesions to achieve safer surgical results