(DTT) This technique has been reported on during the last few years and is the most intriguing demonstration that allows for the noninvasive racking of neuronal fiber projections in a living human brain. White matter fiber trajectories are reconstructed throughout the brain by tracking the direction of fastest diffusion, which is assumed to correspond to the longitudinal axis of the tract. Diffusion tensor tractography should provide new insights into white matter integrity, fiber connectivity, surgical planning, and patients prognosis.

See also B-Value.

(ADC) A diffusion coefficient to differentiate T2 shine through effects or artifacts from real ischemic lesions. In the human brain, water diffusion is a three-dimensional process that is not truly random because the diffusional motion of water is impeded by natural barriers. These barriers are cell membranes, myelin sheaths, white matter fiber tracts, and protein molecules.
The apparent water diffusion coefficients can be calculated by acquiring two or more images with a different gradient duration and amplitude (b-values). The contrast in the ADC map depends on the spatially distributed diffusion coefficient of the acquired tissues and does not contain T1 and T2* values.
The increased sensitivity of diffusion-weighted MRI in detecting acute ischemia is thought to be the result of the water shift intracellularly restricting motion of water protons (cytotoxic edema), whereas the conventional T2 weighted images show signal alteration mostly as a result of vasogenic edema.
The reduced ADC value also could be the result of decreased temperature in the nonperfused tissues, loss of brain pulsations leading to a decrease in apparent proton motion, increased tissue osmolality associated with ischemia, or a combination of these factors. The lower ADC measurements seen with early ischemia, have not been fully established, however, a lower apparent ADC is a sensitive indicator of early ischemic brain at a stage when ischemic tissue remains potentially salvageable.

See also Diffusion Weighted Imaging and Diffusion Tensor Tractography.

(DTI) Diffusion tensor imaging is the more sophisticated form of DWI, which allows for the determination of directionality as well as the magnitude of water diffusion. This kind of MR imaging can estimates damage to nerve fibers that connect the area of the brain affected by the stroke to brain regions that are distant from it, and can be used to determine the effectiveness of stroke prevention medications.
DTI (FiberTrak) enables to visualize white matter fibers in the brain and can map (trace image) subtle changes in the white matter associated with diseases such as multiple sclerosis and epilepsy, as well as assessing diseases where the brain's wiring is abnormal, such as schizophrenia.
The fractional anisotropy (FA) gives information about the shape of the diffusion tensor at each voxel. The FA is based on the normalized variance of the eigenvalues. The fractional anisotropy reflects differences between an isotropic diffusion and a linear diffusion. The FA range is between 0 and 1 (0 = isotropic diffusion, 1 = highly directional).
The development of new imaging methods and some useful analysis techniques, such as 3-dimensional anisotropy contrast (3DAC) and spatial tracking of the diffusion tensor tractography (DTT), are currently under study.

Special imaging primarily means advanced MRI techniques used for qualitative and quantitative measurement of biological metabolism as e.g., spectroscopy, perfusion imaging (PWI, ASL), diffusion weighted imaging (DWI, DTI, DTT) and brain function (BOLD, fMRI). This physiological magnetic resonance techniques offer insights into brain structure, function, and metabolism.
Spectroscopy provides functional information related to identification and quantification of e.g. brain metabolites. MR perfusion imaging has applications in stroke, trauma, and brain neoplasm. MRI provides the high spatial and temporal resolution needed to measure blood flow to the brain. arterial spin labeling techniques utilize the intrinsic protons of blood and brain tissue, labeled by special preparation pulses, rather than exogenous tracers injected into the blood.
MR diffusion tensor imaging characterizes the ability of water to spread across the brain in different directions. Diffusion parallel to nerve fibers has been shown to be greater than diffusion in the perpendicular direction. This provides a tool to study in vivo fiber connectivity in brain MRI.
FMRI allows the detection of a functional activation in the brain because cortical activity is intimately related to local metabolism changes.

See also Diffusion Tensor Tractography.