Surgery of the anterior part of the frontal lobe and of the central region: normative morphometric data based on magnetic resonance imaging.

Modern magnetic resonance imaging (MRI) techniques have improved the planning of surgery to remove lesions in or around the frontal lobe. Since MRI-based morphometric analyses of the anterior part of the frontal lobe and the central region as part of it have not yet been performed, the present study was undertaken to obtain relative normative morphometric data. Median sagittal MRI scans from 53 magnetization prepared rapid acquisition gradient echo (MPRAGE) sequences of individual brains without pathological lesions were analyzed. The AC-PC line (anterior commissure-posterior commissure line) with vertical lines through the AC and PC were chosen as reference lines. Measurements of the anterior part of the frontal lobe included distances between different landmarks (frontal pole, tuberculum sellae, AC, outer point and inner surface of the genu of the corpus callosum, and the cortex at this level). For the measurements around the central region distances were obtained from the following landmarks: coronal suture, central sulcus, marginal sulcus, intersection point of the vertical line through the PC with the cortex, and PC. Knowledge of these distances will allow exact planning of surgical approaches to the anterior part of the frontal lobe, for example, the subfrontal or anterior interhemispheric approach and surgery around the central region.