Intraoperative diffusion-weighted imaging for visualization of the pyramidal tracts. Part I: Pre-clinical validation of the scanning protocol

Integration of intraoperative diffusion-weighted imaging (iDWI) into neuronavigation can be potentially useful for identification of the pyramidal tract during surgery for parenchymal brain lesions. The technique of iDWI using an intraoperative MR scanner of low magnetic field strength (0.3 Tesla) has been developed. For image acquisition, a specially designed solenoid radiofrequency receiver coil integrated with a modified Sugita head holder (head-holder coil) was used. While the sensitivity characteristics of the head-holder coil were found to be 29% lower compared to a diagnostic quadrature head coil, they were sufficient to obtain iDWI images of good quality. The relationship between the angle of the motion probe gradient (MPG) pulse to the vertical axis and pyramidal tract contrasting were examined in 4 healthy men with a mean age of 30 ± 5.7 years. The contrast ratio reached a maximum when the MPG pulse was applied exactly in the anteroposterior direction. The difference of the contrast ratio between right and left sides was not statistically significant. Pyramidal tract visualization became worse and the contrast ratio was reduced when the MPG pulse was applied at different angles to the vertical axis; the reduction rate varied from 20.1 to 27.9% for each 15 degrees of rotation irrespective of its side. In conclusion, the developed scanning protocol for iDWI using an originally designed head-holder coil allowed effective visualization of the pyramidal tracts using an intraoperative MR scanner of low magnetic field strength.