Based on the Wallerian degeneration in the spinal cord pathways,the changes in synaptic connections,and the spinal cord-related cellular responses that alter the cellular structure of the brain,we presumed that brain ...Based on the Wallerian degeneration in the spinal cord pathways,the changes in synaptic connections,and the spinal cord-related cellular responses that alter the cellular structure of the brain,we presumed that brain diffusion tensor imaging(DTI)parameters may change after spinal cord injury.However,the dynamic changes in DTI parameters remain unclear.We established a Beagle dog model of T10 spinal cord contusion and performed DTI of the injured spinal cord.We found dynamic changes in DTI parameters in the cerebral peduncle,posterior limb of the internal capsule,pre-and postcentral gyri of the brain within 12 weeks after spinal cord injury.We then performed immunohistochemistry to detect the expression of neurofilament heavy polypeptide(axonal marker),glial fibrillary acidic protein(glial cell marker),and NeuN(neuronal marker).We found that these pathological changes were consistent with DTI parameter changes.These findings suggest that DTI can display brain structure changes after spinal cord injury.展开更多
Objective： To determine the value of diffusion-tensor imaging （DTI） as an adjunct to dynamic contrastenhanced magnetic resonance imaging （DCE-MRI） for improved accuracy of differential diagnosis between breast du...Objective： To determine the value of diffusion-tensor imaging （DTI） as an adjunct to dynamic contrastenhanced magnetic resonance imaging （DCE-MRI） for improved accuracy of differential diagnosis between breast ductal carcinoma in situ （DCIS） and invasive breast carcinoma （IBC）. Methods： The MRI data of 63 patients pathologically confirmed as breast cancer were analyzed. The conventional MRI analysis metrics included enhancement style, initial enhancement characteristic, maximum slope of increase, time to peak, time signal intensity curve （TIC） pattern, and signal intensity on FS- T2WI. The values of apparent diffusion coefficient （ADC）, directionally-averaged mean diffusivity （D^vg）, exponential attenuation （EA）, fractional anisotropy （FA）, volume ratio （VR） and relative anisotropy （RA） were calculated and compared between DCIS and IBC. Multivariate logistic regression was used to identify independent factors for distinguishing IBC and DCIS. The diagnostic performance of the diagnosis equation was evaluated using the receiver operating characteristic （ROC） curve. The diagnostic efficacies of DCE- MRI, DWI and DTI were compared independently or combined. Results： EA value, lesion enhancement style and TIC pattern were identified as independent factor for differential diagnosis of IBC and DCIS. The combination diagnosis showed higher diagnostic efficacy than a single use of DCE-MRI （P=0.02）, and the area of the curve was improved from 0.84 （95% CI, 0.67-0.99） to 0.94 （95% CI, 0.85-1.00）. Conclusions： Quantitative DTI measurement as an adjunct to DCE-MRI could improve the diagnostic performance of differential diagnosis between DCIS and IBC compared to a single use of DCE-MRI.展开更多
AIM To investigate the utility of renal diffusion tensor imaging(DTI) to detect early renal damage in patients with type 2 diabetes.METHODS Twenty-six diabetic patients(12 with microalbuminuria(MAU), and 14 with normo...AIM To investigate the utility of renal diffusion tensor imaging(DTI) to detect early renal damage in patients with type 2 diabetes.METHODS Twenty-six diabetic patients(12 with microalbuminuria(MAU), and 14 with normoalbuminuria) and fourteen healthy volunteers were prospectively included in this study. Renal DTI on 3.0 T MR was performed, and estimated glomerular filtration rate(e GFR) was recorded for each subject. Mean cortical and medullary fractional anisotropy(FA) values were calculated by placing multiple representative regions of interest. Mean FA values were statistically compared among groups. Correlations between FA values and e GFR were evaluated. RESULTS Both cortical and medullary FA were significantly reduced in diabetic patients compared to healthy controls(0.403 ± 0.064 vs 0.463 ± 0.047, P = 0.004, and 0.556 ± 0.084 vs 0.645 ± 0.076, P = 0.002, respectively). Cortical FA was significantly lower in diabetic patients with NAU than healthy controls(0.412 ± 0.068 vs 0.463 ± 0.047, P = 0.02). Medullary FA in diabetic patients with NAU and healthy controls were similar(0.582 ± 0.096 vs 0.645 ± 0.076, P = 0.06). Both cortical FA and medullary FA correlated with e GFR(r = 0.382, P = 0.015 and r = 0.552, P = 0.000, respectively).CONCLUSION FA of renal parenchyma on DTI might serve as a more sensitive biomarker of early diabetic nephropathy than MAU.展开更多
AIM： To evaluate the effect of an intravenous bolus of mannitol in altering brain metabolites, brain water content, brain parenchyma volume, cerebrospinal fluid （CSF） volume and clinical signs in controls and in pa...AIM： To evaluate the effect of an intravenous bolus of mannitol in altering brain metabolites, brain water content, brain parenchyma volume, cerebrospinal fluid （CSF） volume and clinical signs in controls and in patients with acute liver failure （ALF） and acute- on-chronic liver failure （ACLF）, by comparing changes in conventional magnetic resonance imaging （MRI）, in vivo proton magnetic resonance spectroscopy （PMRS） and diffusion tensor imaging （DTI） before and after its infusion.METHODS： Five patients each with ALF and ACLF in grade 3 or 4 hepatic encephalopathy and with clinical signs of raised intracranial pressure were studied along with five healthy volunteers. After baseline MRI, an intravenous bolus of 20% mannitol solution was given over 10 min in controls as well as in patients with ALF and ACLE Repeat MRI for the same position was acquired 30 rnin after completing the rnannitol injection. RESULTS： No statistically significant difference was observed between controls and patients with ALF and ACLF in metabolite ratios, DTI metrics and brain volume or CSF volume following 45 rain of mannitol infusion. There was no change in clinical status at the end of post-mannitol imaging. CONCLUSION： The osmotic effect of mannitol did not result in significant reduction of brain water content, alteration in metabolite ratios or any change in the clinical status of these patients during or within 45 min of mannitol infusion.展开更多
BACKGROUND： Diffusion tensor imaging （DTI） is one of the noninvasive methods to study the morphological structure of brain white matter fibrous bands in vivo, and it has been applied primarily in clinic. DTI is ack...BACKGROUND： Diffusion tensor imaging （DTI） is one of the noninvasive methods to study the morphological structure of brain white matter fibrous bands in vivo, and it has been applied primarily in clinic. DTI is acknowledged as the more effective imaging method to diagnose ultra-acute and/or acute cerebral infarction.OB_3ECTIVE： To observe the anisotropic characters of cerebral white matter fibrous bands in patients with ischemic stroke by using DTI, and investigate the correlation between the damage of corticospinal tract and muscle strength in patients with ischemic stroke at acute period.DESIGN： A case-control observationSEFIING： Department of Medical Imaging, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA.PARTICIPANTS： Nine inpatients with injury of motor function induced by acute ischemic stroke （patient group） at 6 hours to 2 weeks after the attack were selected from the Department of Neurology, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from September 2005 to March 2006, and they all accorded with the present diagnostic standard for cerebrovascular disease in China. There were 5 males and 4 females, aged 16-87 years. At the same time, nine healthy right-handed physical examinees matched by age and sex with the patients were taken as the control group, and they all had no nervous disease, mental diseases, cerebrovascular abnormalities and injury history, etc. All the subjects were informed with the detected items and agreed to participate in the study.METHODS： All the 9 patients with ischemic stroke at acute period and 9 healthy subjects were examined with MRI, T1 weighted imaging, T2 weighted imaging and DTI. And the data were processed offline with dTV.II software, the images of fractional anisotropy and directional encoded color （DEC） were obtained, and the three-dimensional fibrous band images of bilateral corticospinal tracts were reconstructed. In the control group, the values of fractional anisotropy of main white matter fibrous bands were measured in the region of interest （ROI） of the anterior limb, knee and posterior limb of internal capsule. In the patient group, the values of fractional anisotropy of white matter were measured in the infarcted sites and corresponding contralateral sites of the patients. The ROI was set in bilateral cerebral peduncles to reconstruct three-dimensionally the bilateral corticospinal tracts. The muscle strength of the affected hand was assessed with Brunnstorm standard in the stroke patients.MAIN OUTCOME MEASURES ： The characters of DTI and images of the value of fractional anisotropy, and the manifestations of three-dimensional corticospinal tracts were observed in the two groups.RESULTS： All the data from the 9 patients and 9 healthy volunteers were involved in the analysis of results. In the control group, the white matter and gray matter could be distinguished clearly in the image of fractional anisotropic values, the fibers of different directions were shown by different colors in DEC picture, which clearly demonstrated the normal anatomic structure and direction of white matter fibers. In the patient group, the infarctions occurred in the gray matter or white matter could be distinguished in the images of fractional anisotropic values, DEC picture could clearly show the direct influence of the infarcted site on the white matter fibers. The fractional anisotropic values in different white matter structure of the same side were significantly different in the control group （t=-3.12, P 〈 0.05）, and the reconstructed images fractional anisotropic values and DEC picture could show most of the main white matter fibrous bands. The fractional anisotropic values of the infarcted sites were significantly lower than the contralateral ones in the patient group （t=-5.570, P 〈 0.01）. ② The reconstructed bilateral corticospinal tracts showed that the anatomic forms of the contralateral corticospinal tract of the patients were almost identical to those of normal people, it started from precentral gyrus, downward to the nternal capsule, and extended to pontine and medulla oblongata, each fibrous band was continuous, and the form had good consistency. Because of the involvement of infarction of different severity, the ipsilateral corticospinal tract manifested as continuous interruption and the loss of consistent anatomic structural form. The involved severity of corticospinal tract had significant correlation with that of muscle strength of the ipsilateral hand （r=-1.30, P 〈 0.01）.CONCLUSION： ① DTI can display the direction and distribution of cerebral white matter fibrous bands.② DTI images of fractional anisotropic values and DEC can show the directions and anisotropic degree of white matter fibers in the infarcted sites of stroke patients. ③ The three-dimensional images of fibrous bands can show the conditions of pyramidal tracts more directly. ④ The damaged severity of corticospinal tracts is correlated with that of muscle strength.展开更多
We have recently proposed an optical method for assessing heart structure that uses polarized light measurement of birefringence as an indicator of tissue anisotropy.The highly aligned nature of healthy cardiac muscle...We have recently proposed an optical method for assessing heart structure that uses polarized light measurement of birefringence as an indicator of tissue anisotropy.The highly aligned nature of healthy cardiac muscle tissue has a detectable effect on the polarization of light,resulting in a measurable phase shift(“retardance”).When this organized tissue structure is perturbed,for example after cardiac infarction(heart attack),scar tissue containing disorganized collagen is formed,causing a decrease in the measured retardance values.However,these are dependent not only on tissue anisotropy,but also on the angle between the tissue’s optical anisotropy direction and the beam interrogating the sample.To remove this experimental ambiguity,we present a method that interrogates the sample at two different incident beam angles,thus yielding enough information to uniquely determine the true magnitude and orientation of the tissue optical anisotropy.We use an infarcted porcine heart model to compare these polarimetryderived anisotropy metrics with those obtained with diffusion tensor magnetic resonance imaging(DT-MRI).The latter yields the anisotropy and the direction of tissue water diffusivity,providing an independent measure of tissue anisotropy.The optical and MR results are thus directly compared in a common ex vivo biological model of interest,yielding reasonable agreement but also highlighting some technique-specific differences.展开更多
Purpose: To determine the total direct costs (fixed and variable costs) of diffusion tensor imaging (DTI) and MR tractography reconstruction of the brain. Materials and Methods: The direct fixed and variable costs of ...Purpose: To determine the total direct costs (fixed and variable costs) of diffusion tensor imaging (DTI) and MR tractography reconstruction of the brain. Materials and Methods: The direct fixed and variable costs of DTI with MR tractography were determined prospectively with time and motion analysis in a 1.5-Tesla MR scanner using 15 encoding directions. Seventeen patients with seizure disorders, 9 males & 8 females, with mean age of 13 years (age range 2 - 33 years) were studied. Total direct costs were calculated from all direct fixed and variable costs. Sensitivity analyses between 1.5 versus a 3-Tesla MR system, and 15 versus 32 encoding directions were done. Results: The total direct costs of DTI and MR tractography for a 1.5-T system with 15 encoding directions were US $97. Variable cost was $76.80 and fixed cost was $20.20. Total direct costs for a 3-T system with 15 directions decreased to US $94.5 because of the shorter scan time despite the higher cost of the 3-T system. The most costly component of the direct cost was post-processing analysis at US $46.00. Conclusion: DTI with MR tractography has important total direct costs with variable costs higher than the fixed costs. The post processing variable cost is the most expensive component. Developing more accurate automated post-processing software for DTI and MR tractography is important to decrease this variable labor cost. Given the added value of DTI-MR tractography and the costs involved reimbursement codes should be considered.展开更多
基金supported by the National Natural Science Foundation of China, No. 82102676 (to CBL)a grant from Beijing Municipal Science & Technology Commission, No. Z171100001017076 (to JJL)+1 种基金National Key Research and Development Program, No. 2018YFF0301104 (to JJL)Research on Medical Protection Technology and Application of Induced Neural Stem Cells in the Treatment of Military Spinal Cord Injury, No. Z181100004118004 (to JL)
文摘Based on the Wallerian degeneration in the spinal cord pathways,the changes in synaptic connections,and the spinal cord-related cellular responses that alter the cellular structure of the brain,we presumed that brain diffusion tensor imaging(DTI)parameters may change after spinal cord injury.However,the dynamic changes in DTI parameters remain unclear.We established a Beagle dog model of T10 spinal cord contusion and performed DTI of the injured spinal cord.We found dynamic changes in DTI parameters in the cerebral peduncle,posterior limb of the internal capsule,pre-and postcentral gyri of the brain within 12 weeks after spinal cord injury.We then performed immunohistochemistry to detect the expression of neurofilament heavy polypeptide(axonal marker),glial fibrillary acidic protein(glial cell marker),and NeuN(neuronal marker).We found that these pathological changes were consistent with DTI parameter changes.These findings suggest that DTI can display brain structure changes after spinal cord injury.
基金supported by the National Basic Research Program of China(973 Program)(Grant No.2011CB707705)National Natural Science Foundation of China(Grant No.81471640,81371715)the Capital Health Research and Development of Special Foundation(Grant No.2011-2015-02)
文摘Objective： To determine the value of diffusion-tensor imaging （DTI） as an adjunct to dynamic contrastenhanced magnetic resonance imaging （DCE-MRI） for improved accuracy of differential diagnosis between breast ductal carcinoma in situ （DCIS） and invasive breast carcinoma （IBC）. Methods： The MRI data of 63 patients pathologically confirmed as breast cancer were analyzed. The conventional MRI analysis metrics included enhancement style, initial enhancement characteristic, maximum slope of increase, time to peak, time signal intensity curve （TIC） pattern, and signal intensity on FS- T2WI. The values of apparent diffusion coefficient （ADC）, directionally-averaged mean diffusivity （D^vg）, exponential attenuation （EA）, fractional anisotropy （FA）, volume ratio （VR） and relative anisotropy （RA） were calculated and compared between DCIS and IBC. Multivariate logistic regression was used to identify independent factors for distinguishing IBC and DCIS. The diagnostic performance of the diagnosis equation was evaluated using the receiver operating characteristic （ROC） curve. The diagnostic efficacies of DCE- MRI, DWI and DTI were compared independently or combined. Results： EA value, lesion enhancement style and TIC pattern were identified as independent factor for differential diagnosis of IBC and DCIS. The combination diagnosis showed higher diagnostic efficacy than a single use of DCE-MRI （P=0.02）, and the area of the curve was improved from 0.84 （95% CI, 0.67-0.99） to 0.94 （95% CI, 0.85-1.00）. Conclusions： Quantitative DTI measurement as an adjunct to DCE-MRI could improve the diagnostic performance of differential diagnosis between DCIS and IBC compared to a single use of DCE-MRI.
基金Supported by the Fundamental Research Funds for the Central Universities,University of Electronic Science and Technology of China,No.ZYGX2015J125
文摘AIM To investigate the utility of renal diffusion tensor imaging(DTI) to detect early renal damage in patients with type 2 diabetes.METHODS Twenty-six diabetic patients(12 with microalbuminuria(MAU), and 14 with normoalbuminuria) and fourteen healthy volunteers were prospectively included in this study. Renal DTI on 3.0 T MR was performed, and estimated glomerular filtration rate(e GFR) was recorded for each subject. Mean cortical and medullary fractional anisotropy(FA) values were calculated by placing multiple representative regions of interest. Mean FA values were statistically compared among groups. Correlations between FA values and e GFR were evaluated. RESULTS Both cortical and medullary FA were significantly reduced in diabetic patients compared to healthy controls(0.403 ± 0.064 vs 0.463 ± 0.047, P = 0.004, and 0.556 ± 0.084 vs 0.645 ± 0.076, P = 0.002, respectively). Cortical FA was significantly lower in diabetic patients with NAU than healthy controls(0.412 ± 0.068 vs 0.463 ± 0.047, P = 0.02). Medullary FA in diabetic patients with NAU and healthy controls were similar(0.582 ± 0.096 vs 0.645 ± 0.076, P = 0.06). Both cortical FA and medullary FA correlated with e GFR(r = 0.382, P = 0.015 and r = 0.552, P = 0.000, respectively).CONCLUSION FA of renal parenchyma on DTI might serve as a more sensitive biomarker of early diabetic nephropathy than MAU.
基金The Indian Council of Medical Research (Saksena S), IndiaNew Delhi (Nath K), IndiaThe National Institute of Mental Health,MH58284 and MH06595 (Thomas MA)
文摘AIM： To evaluate the effect of an intravenous bolus of mannitol in altering brain metabolites, brain water content, brain parenchyma volume, cerebrospinal fluid （CSF） volume and clinical signs in controls and in patients with acute liver failure （ALF） and acute- on-chronic liver failure （ACLF）, by comparing changes in conventional magnetic resonance imaging （MRI）, in vivo proton magnetic resonance spectroscopy （PMRS） and diffusion tensor imaging （DTI） before and after its infusion.METHODS： Five patients each with ALF and ACLF in grade 3 or 4 hepatic encephalopathy and with clinical signs of raised intracranial pressure were studied along with five healthy volunteers. After baseline MRI, an intravenous bolus of 20% mannitol solution was given over 10 min in controls as well as in patients with ALF and ACLE Repeat MRI for the same position was acquired 30 rnin after completing the rnannitol injection. RESULTS： No statistically significant difference was observed between controls and patients with ALF and ACLF in metabolite ratios, DTI metrics and brain volume or CSF volume following 45 rain of mannitol infusion. There was no change in clinical status at the end of post-mannitol imaging. CONCLUSION： The osmotic effect of mannitol did not result in significant reduction of brain water content, alteration in metabolite ratios or any change in the clinical status of these patients during or within 45 min of mannitol infusion.
文摘BACKGROUND： Diffusion tensor imaging （DTI） is one of the noninvasive methods to study the morphological structure of brain white matter fibrous bands in vivo, and it has been applied primarily in clinic. DTI is acknowledged as the more effective imaging method to diagnose ultra-acute and/or acute cerebral infarction.OB_3ECTIVE： To observe the anisotropic characters of cerebral white matter fibrous bands in patients with ischemic stroke by using DTI, and investigate the correlation between the damage of corticospinal tract and muscle strength in patients with ischemic stroke at acute period.DESIGN： A case-control observationSEFIING： Department of Medical Imaging, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA.PARTICIPANTS： Nine inpatients with injury of motor function induced by acute ischemic stroke （patient group） at 6 hours to 2 weeks after the attack were selected from the Department of Neurology, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from September 2005 to March 2006, and they all accorded with the present diagnostic standard for cerebrovascular disease in China. There were 5 males and 4 females, aged 16-87 years. At the same time, nine healthy right-handed physical examinees matched by age and sex with the patients were taken as the control group, and they all had no nervous disease, mental diseases, cerebrovascular abnormalities and injury history, etc. All the subjects were informed with the detected items and agreed to participate in the study.METHODS： All the 9 patients with ischemic stroke at acute period and 9 healthy subjects were examined with MRI, T1 weighted imaging, T2 weighted imaging and DTI. And the data were processed offline with dTV.II software, the images of fractional anisotropy and directional encoded color （DEC） were obtained, and the three-dimensional fibrous band images of bilateral corticospinal tracts were reconstructed. In the control group, the values of fractional anisotropy of main white matter fibrous bands were measured in the region of interest （ROI） of the anterior limb, knee and posterior limb of internal capsule. In the patient group, the values of fractional anisotropy of white matter were measured in the infarcted sites and corresponding contralateral sites of the patients. The ROI was set in bilateral cerebral peduncles to reconstruct three-dimensionally the bilateral corticospinal tracts. The muscle strength of the affected hand was assessed with Brunnstorm standard in the stroke patients.MAIN OUTCOME MEASURES ： The characters of DTI and images of the value of fractional anisotropy, and the manifestations of three-dimensional corticospinal tracts were observed in the two groups.RESULTS： All the data from the 9 patients and 9 healthy volunteers were involved in the analysis of results. In the control group, the white matter and gray matter could be distinguished clearly in the image of fractional anisotropic values, the fibers of different directions were shown by different colors in DEC picture, which clearly demonstrated the normal anatomic structure and direction of white matter fibers. In the patient group, the infarctions occurred in the gray matter or white matter could be distinguished in the images of fractional anisotropic values, DEC picture could clearly show the direct influence of the infarcted site on the white matter fibers. The fractional anisotropic values in different white matter structure of the same side were significantly different in the control group （t=-3.12, P 〈 0.05）, and the reconstructed images fractional anisotropic values and DEC picture could show most of the main white matter fibrous bands. The fractional anisotropic values of the infarcted sites were significantly lower than the contralateral ones in the patient group （t=-5.570, P 〈 0.01）. ② The reconstructed bilateral corticospinal tracts showed that the anatomic forms of the contralateral corticospinal tract of the patients were almost identical to those of normal people, it started from precentral gyrus, downward to the nternal capsule, and extended to pontine and medulla oblongata, each fibrous band was continuous, and the form had good consistency. Because of the involvement of infarction of different severity, the ipsilateral corticospinal tract manifested as continuous interruption and the loss of consistent anatomic structural form. The involved severity of corticospinal tract had significant correlation with that of muscle strength of the ipsilateral hand （r=-1.30, P 〈 0.01）.CONCLUSION： ① DTI can display the direction and distribution of cerebral white matter fibrous bands.② DTI images of fractional anisotropic values and DEC can show the directions and anisotropic degree of white matter fibers in the infarcted sites of stroke patients. ③ The three-dimensional images of fibrous bands can show the conditions of pyramidal tracts more directly. ④ The damaged severity of corticospinal tracts is correlated with that of muscle strength.
基金Support from the Natural Sciences and Engineering Research Council of Canada,the Canadian Institutes of Health Research and the Canadian Foundation for Innovation,is gratefully acknowledged
文摘We have recently proposed an optical method for assessing heart structure that uses polarized light measurement of birefringence as an indicator of tissue anisotropy.The highly aligned nature of healthy cardiac muscle tissue has a detectable effect on the polarization of light,resulting in a measurable phase shift(“retardance”).When this organized tissue structure is perturbed,for example after cardiac infarction(heart attack),scar tissue containing disorganized collagen is formed,causing a decrease in the measured retardance values.However,these are dependent not only on tissue anisotropy,but also on the angle between the tissue’s optical anisotropy direction and the beam interrogating the sample.To remove this experimental ambiguity,we present a method that interrogates the sample at two different incident beam angles,thus yielding enough information to uniquely determine the true magnitude and orientation of the tissue optical anisotropy.We use an infarcted porcine heart model to compare these polarimetryderived anisotropy metrics with those obtained with diffusion tensor magnetic resonance imaging(DT-MRI).The latter yields the anisotropy and the direction of tissue water diffusivity,providing an independent measure of tissue anisotropy.The optical and MR results are thus directly compared in a common ex vivo biological model of interest,yielding reasonable agreement but also highlighting some technique-specific differences.
文摘Purpose: To determine the total direct costs (fixed and variable costs) of diffusion tensor imaging (DTI) and MR tractography reconstruction of the brain. Materials and Methods: The direct fixed and variable costs of DTI with MR tractography were determined prospectively with time and motion analysis in a 1.5-Tesla MR scanner using 15 encoding directions. Seventeen patients with seizure disorders, 9 males & 8 females, with mean age of 13 years (age range 2 - 33 years) were studied. Total direct costs were calculated from all direct fixed and variable costs. Sensitivity analyses between 1.5 versus a 3-Tesla MR system, and 15 versus 32 encoding directions were done. Results: The total direct costs of DTI and MR tractography for a 1.5-T system with 15 encoding directions were US $97. Variable cost was $76.80 and fixed cost was $20.20. Total direct costs for a 3-T system with 15 directions decreased to US $94.5 because of the shorter scan time despite the higher cost of the 3-T system. The most costly component of the direct cost was post-processing analysis at US $46.00. Conclusion: DTI with MR tractography has important total direct costs with variable costs higher than the fixed costs. The post processing variable cost is the most expensive component. Developing more accurate automated post-processing software for DTI and MR tractography is important to decrease this variable labor cost. Given the added value of DTI-MR tractography and the costs involved reimbursement codes should be considered.
