Chakraborty Aabir, McEvoy Andrew W
Victor Horsley Department of Neurosurgery, National Hospital for Neurology & Neurosurgery, London, UK.
Curr Opin Neurol. 2008 Aug;21(4):446-51. doi: 10.1097/WCO.0b013e32830866e2.
The present article describes current indications for functional MRI in the preoperative planning of neurosurgical patients. Functional MRI continues to have an expanding role.
There are three main categories of patients who commonly undergo preoperative functional MRI. Patients with lesions close to eloquent cortex can benefit from preoperative functional MRI to assess resectability and reduce the possibility of functional deficit. The second group are those patients who have functional MRI as part of their preoperative planning to localize language dominance and for functional localization of memory. The final group are those patients in whom attempts are made to image and localize abnormal brain function. This has a specific application in the field of epilepsy surgery (electroencephalographic-correlated functional MRI). These three roles require different spatial resolutions. Advances in multimodality imaging are enabling more accurate localization of function intraoperatively.
It is hoped that the increasing use of functional MRI in combination with both preoperative and intraoperative imaging modalities may reduce the risk of neurological deficit while improving completeness of resection. Electroencephalographic-correlated functional MRI may provide an additional method for localization of epileptogenic foci.
本文描述了功能磁共振成像在神经外科手术患者术前规划中的当前适应证。功能磁共振成像的作用持续扩大。
通常接受术前功能磁共振成像检查的患者主要有三大类。靠近明确功能区皮质的病变患者可从术前功能磁共振成像中受益，以评估可切除性并降低功能缺损的可能性。第二类是那些将功能磁共振成像作为术前规划一部分以确定语言优势半球和进行记忆功能定位的患者。最后一类是那些试图对异常脑功能进行成像和定位的患者。这在癫痫手术领域（脑电图相关功能磁共振成像）有特定应用。这三种作用需要不同的空间分辨率。多模态成像的进展使术中功能定位更准确。
希望功能磁共振成像与术前和术中成像方式的联合应用增加，可降低神经功能缺损风险，同时提高切除的完整性。脑电图相关功能磁共振成像可为癫痫灶定位提供额外方法。
