Diffusion Tensor Tractography in the Head-and-Neck Region Using a Clinical 3-T MR Scanner

Rationale and Objectives Diffusion tensor tractography (DTT) for neural fibers of the head-and-neck region at 3T has not been reported. The purpose of this study was to evaluate the feasibility of using DTT for visualizing neural fibers in the head-and-neck region at 3T and to explore the use of this method in patients with head-and-neck mass lesions. Materials and Methods Using a 3T scanner, we obtained magnetic resonance images of the head and neck region in 5 healthy volunteers and 5 patients with head and neck mass lesions. All subjects underwent anatomic T1-weighted and diffusion-tensor imaging using a sequence with six motion-probing gradient orientations, a b value of 800 second/mm 2 , and a 128 × 128 pixel matrix. Fiber tracking was with the continuous tracking method. Different postprocessing parameters were investigated to optimize fiber density detection and minimize noise. In five patients with head-and-neck mass lesions, comparison of tractography results and operative findings with regards to mass and nerve relationship was also performed by two observers. Results Using the two regions-of-interest method, the greatest fiber density of presumed inferior alveolar nerves was depicted at a maximum angle of 40° and a minimum fiber length of 10 mm. DTT was successfully depicted in all 5 patients. In 4 patients, the relationship between DTT and operative findings was coincided or similar. The interobserver agreement was good. Conclusions DTT of the neural fibers in the head and neck region is feasible using a clinical 3T magnetic resonance scanner. Data from a small number of patients with head-and-neck lesions show good agreement between tractography and operative results.