Diffusion tensor tractography of the somatosensory system in the human brainstem: initial findings using high isotropic spatial resolution at 3.0 T.

Lack of adequate sensitivity and spatial resolution in previous noninvasive imaging studies has impeded the depiction of different somatosensory pathways (the medial lemniscus and spinal lemniscus). We investigated whether incorporation of diffusion tensor imaging (DTI) at high isotropic spatial resolution and DTI-based 3D fiber-tractography information can facilitate the study of anatomical parcellation of the somatosensory system in the healthy adult human brainstem. Five healthy men (age range 24-37 years) were studied, and written informed consent was obtained from all subjects. Three-Tesla MRI diffusion tensor tractography (DTT) using fiber assignment by the continuous tracking (FACT) approach at high spatial resolution was used to reconstruct three white matter tracts, the medial lemniscus (ML), spinal lemniscus (SL), and central tegmental tract (CTT), to delineate and quantify the sensory pathways within the brainstem. We demonstrate that these three pathways are distinguishable from each other. The tractographic patterns of the three pathways on all subjects were similar and consistent with atlases of anatomy. We also quantified the diffusion tensor metrics (fractional anisotropy and mean diffusivity) of the two somatosensory pathways, the SL and ML. The fractional anisotropy of the ML was significantly higher than that of the SL (p = 0.005) The average diffusivity was significantly smaller for the ML than for the SL (p = 0.003).