Hattingen Elke, Good Catriona, Weidauer Stefan, Herminghaus Sebastian, Raab Peter, Marquardt Gerhard, Raabe Andreas, Seifert Volker, Zanella Friedhelm E
Institute of Neuroradiology, Department of Neurosurgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany.
J Neurosurg. 2005 Feb;102(2):302-10. doi: 10.3171/jns.2005.102.2.0302.
The goal of this study was to evaluate a novel form of brain surface representation that allows simple, reliable mapping of the surface neuroanatomy for the preoperative evaluation of the spatial relationship between a focal lesion and the precentral gyrus.
High-resolution three-dimensional (3D) magnetic resonance (MR) imaging data sets were postprocessed using a curved multiplanar reformatting technique to create brain surface reformatted (BSR) images. These BSR images were reconstructed in less than 5 minutes and demonstrated the entire central sulcus with adjacent surface structures in one view. Two experienced neuroradiologists determined the localization of lesions near the central sulcus in 27 patients on standard MR images in three orthogonal planes and on BSR images. In addition, these observers judged whether the lesions were easy or difficult to localize on standard MR and BSR images, and whether diagnoses based on these methods were certain or doubtful. Anatomical localization based on BSR images was compared with that based on functional MR (fMR) images or intraoperative mapping of motor function. The BSR images yielded a perfect concordance with the fMR images and intraoperative mapping (Cohen kappa 1.0) and optimal diagnostic accuracy in localizing perirolandic lesions (both sensitivity and specificity were 100%). Localization was judged to be easy for 48 of 54 diagnoses based on BSR images compared with 26 of 54 based on standard MR images. Diagnoses were assessed as certain for 52 cases based on BSR images and 34 cases based on standard MR images.
Brain surface reformatted imaging improves the diagnostic accuracy of standard anatomical MR imaging for localizing superficial brain lesions in relation to the precentral gyrus. The complementary use of this technique with standard two-dimensional imaging is supported by the fast and simple postprocessing technique and may provide useful information for preoperative surgical planning.
本研究的目的是评估一种新型脑表面呈现形式，该形式能够为局灶性病变与中央前回之间的空间关系进行术前评估，实现脑表面神经解剖结构的简单、可靠映射。
使用曲面多平面重新格式化技术对高分辨率三维（3D）磁共振（MR）成像数据集进行后处理，以创建脑表面重新格式化（BSR）图像。这些BSR图像在不到5分钟的时间内重建完成，并在一个视图中展示了整个中央沟及其相邻的表面结构。两名经验丰富的神经放射科医生在标准MR图像的三个正交平面以及BSR图像上，确定了27例患者中央沟附近病变的位置。此外，这些观察者判断病变在标准MR图像和BSR图像上定位的难易程度，以及基于这些方法的诊断是确定的还是可疑的。将基于BSR图像的解剖定位与基于功能MR（fMR）图像或运动功能术中映射的定位进行比较。BSR图像与fMR图像和术中映射具有完美的一致性（Cohen卡帕系数为1.0），并且在定位中央旁小叶周围病变方面具有最佳诊断准确性（敏感性和特异性均为100%）。基于BSR图像的54例诊断中有48例被判定定位容易，而基于标准MR图像的54例诊断中只有26例被判定定位容易。基于BSR图像的52例诊断被评估为确定，基于标准MR图像的34例诊断被评估为确定。
脑表面重新格式化成像提高了标准解剖MR成像在定位浅表脑病变与中央前回关系方面的诊断准确性。该技术与标准二维成像的互补使用得到了快速简单的后处理技术的支持，并且可能为术前手术规划提供有用信息。
