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Diffusion-Tensor MR Tractography of Somatotopic Organization of Corticospinal Tracts in the Internal Capsule: Initial Anatomic Results in Contradistinction to Prior Reports¹

Andrei I. Holodny, MD, Devang M. Gor, DMRD, Richard Watts, PhD, Philip H. Gutin, MD and Aziz M. Ulu, PhD

¹ From the Functional MRI Laboratory, Departments of Radiology (A.I.H.) and Neurosurgery (P.H.G.), Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10021; Department of Radiology, UMDNJ–New Jersey Medical School, Newark, NJ (D.M.G.); and Department of Radiology, Weill Medical College of Cornell University, New York, NY (R.W., A.M.U.). From the 2003 RSNA Scientific Assembly. Received December 22, 2003; revision requested February 24, 2004; revision received May 6; accepted May 24. Address correspondence to A.I.H. (e-mail: holodnya@mskcc.org).

The goal of this study was to use diffusion-tensor magnetic resonance (MR) imaging to define the location and organization of corticospinal tracts (CSTs) in the posterior limb of the internal capsule (PLIC). The Institutional Review Board approved the study, and informed consent was obtained from all subjects. Eight volunteers and two patients with brain tumor were imaged at 3 T. All CSTs were found to lie in a compact area in one part of the PLIC: If the PLIC is divided into four equal quarters from anterior to posterior, the CST was shown to be in the third quarter. Seventeen of 20 CSTs were organized somatotopically, with hand fibers anterolateral to foot fibers, not anteromedial as is currently believed. In three of 20, hand and foot fibers were intermixed. Classically, it was thought that the CST was located in the anterior third of the PLIC. The present data confirm recent results that the CST is located more posteriorly. In the majority of cases, however, the CST is organized somatotopically.

© RSNA, 2005

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