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Brain cystic lesions is significant neurosurgical dilemma. Differencing cystic brain lesions by CT and conventional MRI may be difficult due to similar findings clinically and similar appearance radiologically, On conventional MRI most of the lesions appear hyper intense on T2-WI and hypo intense on T1-WI. The aim of this study was to assess the role of magnetic resonance diffusion tensor tractography in the assessment and differentiation between cystic brain lesions. The study was a prospective one that was conducted on 30 patients who were suspected to have cystic brain lesions and referred to radio diagnosis department from the neuro-surgery department and outpatient clinics of Tanta university hospitals. In this study mean age of patients was 43.453 + 12.23 years, their age ranged from 5 - 60 years. DTI guides the surgeons regarding the relation between the intra-axial tumor and local WM tracts in different planes. A variety of aspects of the tumor–tract relationship can, therefore, be revealed. The nature of the tract can be suggested from its position and course, such as the corticospinal tract (CST) and optic radiations, and effect of the tumor to the tract can be appreciated. Furthermore, the location of the tumor can be seen in relation to the tract. Neurosurgery for brain tumors is comparison between maximum surgical resection on one hand and maximum sparing of functions on other hand. Total resection of the tumor reduces risk of relapse and permits following radiotherapy or chemotherapy to be much more effective.

Magnetic Resonance Diffusion Tensor Tractography in Assessment of Cystic Brain Lesions