Discussing the Diffusion Tensor Imaging without Complex Statistical Analysis Could Be Helpful for Diagnosis

Objective: Thanks to fast developing technology, visualization of fiber tracts at brain is possible. But
with the new developments, data processing and interpretation are becoming more difficult. Actually
interpretations in these fields are mostly in-group analysis and are generally not useful on the basis of
individual patient evaluations. In these regards, we investigated our cases with diffusion tensor
imaging (DTI) and tried to show if the data could be interpreted simply by radiologist’s eye or not.
Materials: Our study consisted of 31 cases that were evaluated in our center with 3 Tesla Magnetic
Resonance Imaging (MRI) units. Cranial DTI studies performed for ischemia, posttraumatic axonal
injury, congenital malformation, neoplasia, autism, mental retardation and epilepsy. Cranial DTI was
performed to demonstrate effected fiber tracts in neoplasia and ischemia cases and was applied to
identify any gross anomaly in micro structural anatomy beside normal conventional MRI in other
cases. DTI images were evaluated, along with fused conventional T1 weighted 3D high-resolution
images and FA maps. DTI were performed at the first administration of the patients.
Results: In addition to chronic ischemic focuses in patients with ischemia, DTI-FA images showed us
relevant signal changes secondary to Wallerian degeneration in two cases. In traumatic brain injury
cases, though being isointense on conventional sequences, FA values showed decreased values at
the levels of the axonal discontinuity. Major abnormalities of association and projection fibers in
congenital malformation cases were visualized at both 3D-DTI fused images and FA map images.
Displacement, infiltration, destruction fibers were clearly visualized in neoplasia cases. However, any
objective abnormality wasn’t reported at any cases diagnosed with motor mental retardation, epilepsy
or neuropsychiatric diseases.
Conclusion: In conclusion, although it doesn’t provide concrete and case-specific valuable
information to radiologists, especially in cases with microstructural anomalies like neuropsychiatric
disorders, epilepsy and motor-mental retardation; in most cases with organic pathologies, it is
possible to obtain diagnostic information by DTI-FA maps and 3D-trac- tography’s images. Indeed,
currently used statistical analysis programs could show microstructural anomalies as well as growing
steadily and this area is the subject of ongoing research.