Schreiber A, Hubbe U, Ziyeh S, Hennig J
Department of Neurology, Albert-Ludwigs-University, Freiburg, Germany.
AJNR Am J Neuroradiol. 2000 Jun-Jul;21(6):1055-63.
Functional MR (fMR) imaging with blood-oxygen-level-dependent (BOLD) contrast enhancement is increasingly used as a noninvasive tool for presurgical mapping in patients with intracranial tumors. Most physiologic studies of task-related BOLD contrast enhancement have involved healthy volunteers. Therefore, it is not known whether BOLD contrast is evoked in the same way in or adjacent to tumor tissue. The purpose of this study was to study the influence of different intracranial tumors on BOLD contrast enhancement.
fMR mapping of the sensorimotor cortex was successfully performed in 15 of 21 patients with intracranial space-occupying lesions by using a bimanual motor task. Tumors were located either within the sensorimotor area itself or in adjacent brain areas, inducing changes of signal intensity on T2-weighted images along the pre- or postcentral gyrus. Space-occupying lesions were divided into a group comprising gliomas (seven cases) and a group comprising nonglial space-occupying lesions (three metastases, two cavernomas, one abscess, one arteriovenous malformation, one meningioma). A hemispheric activation index was calculated using the volume of activation on the affected and on the contralateral hemisphere. Hemispheric activation indices of gliomas and nonglial lesions were compared statistically.
The activated volume in the hemispheres ipsilateral to the nonglial lesions was 14% larger than in the contralateral hemisphere, whereas in the hemispheres ipsilateral to gliomas, the activated volume decreased by 36% in comparison with the contralateral hemisphere. The difference between nonglial lesions and gliomas was significant (P < .05).
The generation of BOLD contrast enhancement is reduced near gliomas but is not affected by nonglial tumors.
基于血氧水平依赖（BOLD）对比增强的功能磁共振（fMR）成像越来越多地被用作颅内肿瘤患者术前定位的非侵入性工具。大多数与任务相关的BOLD对比增强的生理学研究都涉及健康志愿者。因此，尚不清楚在肿瘤组织内或其附近，BOLD对比是否以相同方式被诱发。本研究的目的是探讨不同颅内肿瘤对BOLD对比增强的影响。
通过双手运动任务，成功地对21例颅内占位性病变患者中的15例进行了感觉运动皮层的fMR定位。肿瘤位于感觉运动区本身或相邻脑区，导致沿中央前回或中央后回的T2加权图像上信号强度发生变化。占位性病变分为胶质瘤组（7例）和非胶质瘤占位性病变组（3例转移瘤、2例海绵状血管瘤、1例脓肿、1例动静脉畸形、1例脑膜瘤）。使用患侧和对侧半球的激活体积计算半球激活指数。对胶质瘤和非胶质瘤病变的半球激活指数进行统计学比较。
非胶质瘤病变同侧半球的激活体积比 contralateral hemisphere大14%，而胶质瘤同侧半球的激活体积与 contralateral hemisphere相比减少了36%。非胶质瘤病变与胶质瘤之间的差异具有统计学意义（P <.05）。
胶质瘤附近BOLD对比增强的产生减少，但不受非胶质瘤的影响。
