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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).

View larger version (108K): [in a new window]   Figure 1a. (a) Right and (b) left posterior oblique renderings of CST traces superimposed on T2-weighted MR images (4000/102) in a 40-year-old healthy male volunteer. Posterior part of brain is toward the viewer. On a, hand CST is red and foot CST is green. On b, hand CST is green and foot CST is blue. CST is seen to traverse the third quarter of the PLIC. If PLIC is divided into four equal quarters from anterior to posterior, CST was shown to be in the third quarter. Hand CST is lateral and slightly anterior to foot CST, which is the same relationship as hand homunculus to foot homunculus in the precentral gyrus. These findings contradict the current understanding of the relationship of the CSTs of foot and hand in the PLIC. On a, there is some intermingling of CSTs of hand and foot.

View larger version (115K): [in a new window]   Figure 1b. (a) Right and (b) left posterior oblique renderings of CST traces superimposed on T2-weighted MR images (4000/102) in a 40-year-old healthy male volunteer. Posterior part of brain is toward the viewer. On a, hand CST is red and foot CST is green. On b, hand CST is green and foot CST is blue. CST is seen to traverse the third quarter of the PLIC. If PLIC is divided into four equal quarters from anterior to posterior, CST was shown to be in the third quarter. Hand CST is lateral and slightly anterior to foot CST, which is the same relationship as hand homunculus to foot homunculus in the precentral gyrus. These findings contradict the current understanding of the relationship of the CSTs of foot and hand in the PLIC. On a, there is some intermingling of CSTs of hand and foot.

View larger version (107K): [in a new window]   Figure 2. Right posterior oblique rendering of CST traces superimposed on T2-weighted MR image (4000/102) in a 42-year-old woman with right posterior temporal lobe tumor. Orientation and designations are same as in Figure 1. CST is again seen to traverse the third quarter of the PLIC. Hand CST is again lateral and slightly anterior to foot CST.

View larger version (102K): [in a new window]   Figure 3a. Trace of foot CST in a healthy 40-year-old male volunteer. (a) CST (blue) is superimposed on sagittal spin-echo echo-planar MR image (10 000/100). The two red lines indicate transverse sections of different obliquities through CST. (b, c) Corresponding transverse spin-echo echo-planar MR sections (10 000/100). Clearly, anatomic location of CST does not change; rather, only its apparent anterior-posterior location changes. This difference in section angulation may account for the different interpretations of relative position of the CST.

View larger version (87K): [in a new window]   Figure 3b. Trace of foot CST in a healthy 40-year-old male volunteer. (a) CST (blue) is superimposed on sagittal spin-echo echo-planar MR image (10 000/100). The two red lines indicate transverse sections of different obliquities through CST. (b, c) Corresponding transverse spin-echo echo-planar MR sections (10 000/100). Clearly, anatomic location of CST does not change; rather, only its apparent anterior-posterior location changes. This difference in section angulation may account for the different interpretations of relative position of the CST.

View larger version (94K): [in a new window]   Figure 3c. Trace of foot CST in a healthy 40-year-old male volunteer. (a) CST (blue) is superimposed on sagittal spin-echo echo-planar MR image (10 000/100). The two red lines indicate transverse sections of different obliquities through CST. (b, c) Corresponding transverse spin-echo echo-planar MR sections (10 000/100). Clearly, anatomic location of CST does not change; rather, only its apparent anterior-posterior location changes. This difference in section angulation may account for the different interpretations of relative position of the CST.