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 x 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 degrees 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.