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Acta Neurochirurgica

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01.06.2015 | Clinical Article - Neurosurgical Techniques

Tractography of Meyer’s loop for temporal lobe resection—validation by prediction of postoperative visual field outcome‬‬‬‬

verfasst von: Ylva Lilja, Maria Ljungberg, Göran Starck, Kristina Malmgren, Bertil Rydenhag, Daniel T. Nilsson

Erschienen in: Acta Neurochirurgica | Ausgabe 6/2015

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Abstract

Background

Postoperative visual field defects are common after temporal lobe resection because of injury to the most anterior part of the optic radiation, Meyer’s loop. Diffusion tensor tractography is a promising technique for visualizing the optic radiation preoperatively. The aim of this study was to assess the anatomical accuracy of Meyer’s loop, visualized by the two most common tractography methods—deterministic (DTG) and probabilistic tractography (PTG)—in patients who had undergone temporal lobe resection.

Methods

Eight patients with temporal lobe resection for temporal lobe pathology were included. Perimetry and diffusion tensor imaging were performed pre- and postoperatively. Two independent operators analyzed the distance between the temporal pole and Meyer’s loop (TP-ML) using DTG and PTG. Results were compared to each other, to data from previously published dissection studies and to postoperative perimetry results. For the latter, Spearman’s rank correlation coefficient (r_s) was used.

Results

Median preoperative TP-ML distances for nonoperated sides were 42 and 35 mm, as determined by DTG and PTG, respectively. TP-ML assessed with PTG was a closer match to dissection studies. Intraclass correlation coefficients were 0.4 for DTG and 0.7 for PTG. Difference between preoperative TP-ML (by DTG and PTG, respectively) and resection length could predict the degree of postoperative visual field defects (DTG: r_s = −0.86, p < 0.05; PTG: r_s = −0.76, p < 0.05).

Conclusion

Both DTG and PTG could predict the degree of visual field defects. However, PTG was superior to DTG in terms of reproducibility and anatomical accuracy. PTG is thus a strong candidate for presurgical planning of temporal lobe resection that aims to minimize injury to Meyer’s loop.

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Titel: Tractography of Meyer’s loop for temporal lobe resection—validation by prediction of postoperative visual field outcome‬‬‬‬
verfasst von: Ylva Lilja
Maria Ljungberg
Göran Starck
Kristina Malmgren
Bertil Rydenhag
Daniel T. Nilsson
Publikationsdatum: 01.06.2015
Verlag: Springer Vienna
Erschienen in: Acta Neurochirurgica / Ausgabe 6/2015
Print ISSN: 0001-6268
Elektronische ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-015-2403-y

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Tractography of Meyer’s loop for temporal lobe resection—validation by prediction of postoperative visual field outcome‬‬‬‬

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