A 38-year-old right-handed male presented with left glioblastoma, suffering from weakness in his right upper and lower extremities. MRI examination revealed an intra-axial tumor in the left temporal-parietal region. His language function was normal. The FA map showed decreased intralesional FA value, indicating the infiltration and destruction of WM tracts. The color-coded map showed complete disruption of the WM tracts of inferior fronto-occipital fasciculus (IFO) fibers. 3-D fiber tractography showed the intact left corticospinal tract (CST) in close relation to the lesion. The left CST was shown to be compressed and deviated medially by the mass lesion. The left arcuate fasciculus (AF) was seen away from the lesion, and unaffected by the same. Normal intact left-sided CST, IFO and AF tracts are shown for comparison. The tumor was resected maximally, avoiding the CST and AF, and was followed by chemoradiation (Figure ).
A 37-year-old man was admitted to our hospital with weakness of the right limbs and speech and memory loss. Muscle strength in the right-side extremities was grade 4 according to Lovett's testing. A mass lesion involving the left basal ganglia, thalamus and internal capsule was detected on routine magnetic resonance imaging (MRI) with low T1-signal intensity and high T2-signal intensity. The DTI showed a lower value of FA in the affected white matter (0.08-0.24) compared to the contralateral side. DTI-based fiber-tracking displayed a reduced fiber tract on the left CST, and partially interrupted in the lesion area (fig. ). Fiber bundles slightly increased but were still interrupted using an FA cut-off value of 0.10 for fiber-tracking. Diagnosis of diffuse astrocytoma was made after biopsy and histopathological results.