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Diffusion Tensor Imaging Tractography Detecting Isolated Oculomotor Paralysis Caused by Pituitary Apoplexy
Xiaolin Hou1, Chengxun Li1, Dongdong Yang1
1School of Clinical Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu.
The Neurologist
|November 12, 2020
Summary
Diffusion tensor imaging (DTI) tractography visualized oculomotor nerve damage in pituitary apoplexy (PA)-induced oculomotor palsy. DTI tractography showed nerve disruption and restoration of integrity, correlating with symptom improvement.
Area of Science:
- Neuroimaging
- Neurology
- Ophthalmology
Background:
- Pituitary apoplexy (PA) can rarely cause oculomotor palsy due to cavernous sinus compression.
- Standard examinations may not fully capture oculomotor nerve damage in PA.
Purpose of the Study:
- To visualize PA-induced oculomotor nerve damage using diffusion tensor imaging (DTI) tractography.
- To assess the feasibility of DTI tractography in evaluating oculomotor nerve integrity in PA.
Main Methods:
- Enrolled 5 patients with PA-induced oculomotor palsy and 10 healthy controls.
- Performed preoperative DTI tractography, measuring fractional anisotropy (FA) and mean diffusion (MD) values of the oculomotor nerve.
- Repeated DTI tractography post-recovery.
Main Results:
- Oculomotor nerves on the affected side showed disrupted FA and MD values in PA patients compared to controls (P<0.01).
- Post-recovery, FA values increased and MD values decreased in affected nerves (P<0.01), with DTI tractography showing restored nerve integrity.
- All patients experienced symptom improvement within 7 days postoperatively.
Conclusions:
- DTI tractography is feasible for visualizing PA-induced oculomotor nerve damage.
- DTI tractography can serve as a valuable adjunct to standard clinical examinations for PA-induced oculomotor palsy.
