Stippich Christoph, Rapps Nora, Dreyhaupt Jens, Durst Anita, Kress Bodo, Nennig Ernst, Tronnier Volker M, Sartor Klaus
Division of Neuroradiology, Department of Neurology, University of Heidelberg Medical School, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
Radiology. 2007 Jun;243(3):828-36. doi: 10.1148/radiol.2433060068.
To prospectively assess the feasibility of standardized presurgical functional magnetic resonance (MR) imaging for localizing the Broca and Wernicke areas and for lateralizing language function.
The study was approved by the responsible ethics commission, and patients gave written informed consent. Eighty-one patients (36 female and 45 male patients; age range, 7-75 years) with different brain tumors underwent blood oxygen level-dependent functional MR imaging at 1.5 T with two paradigms: sentence generation (SG) and word generation (WG). Functional MR imaging measurements, data processing, and evaluation were fully standardized by using dedicated software. Four regions of interest were evaluated in each patient: the Broca and Wernicke areas and their anatomic homologues in the right hemisphere. Statistics were calculated.
The SG and WG paradigms were successfully completed by all (100%) and 70 (86%) patients, respectively. Success rates in localizing and lateralizing language were 96% for the Broca and Wernicke areas with the SG paradigm, 81% for the Broca area and 80% for the Wernicke area with the WG paradigm, and 98% for both areas when the SG and WG paradigms were used in combination. Functional localizations were consistent for SG and WG paradigms in the inferior frontal gyrus (Broca area) and the superior temporal, supramarginal, and angular gyri (Wernicke area). Surgery was not performed in seven patients (9%) and was modified in two patients (2%) because of functional MR imaging findings.
Functional MR imaging proved to be feasible during routine diagnostic neuroimaging for localizing and lateralizing language function preoperatively.
前瞻性评估标准化术前功能磁共振成像（MR）定位布洛卡区和韦尼克区以及确定语言功能偏侧化的可行性。
本研究经相关伦理委员会批准，患者均签署了书面知情同意书。81例（36例女性和45例男性；年龄范围7 - 75岁）患有不同脑肿瘤的患者在1.5T磁场下采用两种模式进行血氧水平依赖性功能MR成像：句子生成（SG）和单词生成（WG）。使用专用软件对功能MR成像测量、数据处理和评估进行了全面标准化。对每位患者的四个感兴趣区域进行评估：布洛卡区、韦尼克区及其右半球的解剖学对应区域。进行了统计学计算。
SG和WG模式分别成功完成的患者为所有81例（100%）和70例（86%）。SG模式下布洛卡区和韦尼克区定位及确定语言功能偏侧化的成功率为96%，WG模式下布洛卡区为81%，韦尼克区为80%，SG和WG模式联合使用时两个区域的成功率为98%。SG和WG模式在额下回（布洛卡区）以及颞上回、缘上回和角回（韦尼克区）的功能定位一致。7例（9%）患者未进行手术，2例（2%）患者因功能MR成像结果改变了手术方案。
功能MR成像在常规诊断性神经成像期间被证明对于术前定位和确定语言功能偏侧化是可行的。
