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Diffusion tensor tractography should be used with caution

机译:应谨慎使用弥散张量束造影

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摘要

I read the article by Saur et al. (1) with interest. The authors state that they succeeded in in vivo depiction of the dualstream model for language processing,which has been recently suggested by Hickok et al. (2,3). These fibers are known to course through the extreme capsule (EmC),which is a fiber bundle that is located lateral to the external capsule (EC),divided by a thin layer of gray matter known as the claustrum. The authors of this article have combined functional MRI and probabilistic tractography to show that higher- level language comprehension is mediated by a ventral pathway,running in an anteroposterior direction within the EmC. The data seemed convincing until I tried to reproduce their results using my own dataset obtained by using a similar spatial resolution (2 2 -2 mm) (4). By carefully looking into the color-coded vector map (Fig. 1),I immediately noticed that the fiber direction of the EmC is not anteroposterior but rather transverse or superoinferior in the transaxial plane (indicated by the deep purple color). On the other hand,the EC had fibers running in an anteroposterior direction (shown in green). It thus seems that their probabilistic tractography has erroneously picked the EC (rather than the EmC) to elucidate an imaginary fiber tract connecting the temporal lobe and the ventrolateral prefrontal cortex. As a clinician,I have been using this tool (tractography) with the greatest caution,because all that we see on these intriguing images may not precisely reflect the reality (5). I think that the results of Saur et al. (1) represent another example of such false positive/negative results.
机译:我饶有兴趣地阅读了 Saur 等人 (1) 的文章。作者指出,他们成功地在体内描绘了用于语言处理的双流模型,这是 Hickok 等人最近提出的 (2,3)。已知这些纤维会穿过极端胶囊 (EmC),这是位于外胶囊 (EC) 外侧的纤维束,由一层称为幽闭的薄灰质分隔。本文的作者将功能性 MRI 和概率束成像相结合,表明高级语言理解是由 EmC 内前后方向的腹侧通路介导的。这些数据似乎很有说服力,直到我尝试使用我自己的数据集来重现他们的结果,这些数据集是通过使用类似的空间分辨率(2,2-2 mm)获得的(4)。通过仔细观察颜色编码的矢量图(图1),我立即注意到EmC的纤维方向不是前后,而是横向或上下,在跨轴平面上(由深紫色表示)。另一方面,EC的纤维向前后方向运行(显示为绿色)。因此,他们的概率束成像似乎错误地选择了EC(而不是EmC)来阐明连接颞叶和腹外侧前额叶皮层的假想纤维束。作为一名临床医生,我一直在非常谨慎地使用这个工具(牵引成像),因为我们在这些有趣的图像上看到的所有东西可能并不能精确地反映现实(5)。我认为Saur等人(1)的结果代表了这种假阳性/假阴性结果的另一个例子。

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