Division of Neurosurgery, Department of Neurological Sciences, Università degli Studi di Milano, 20122 Milan, Italy.
Neurosurg Focus. 2010 Feb;28(2):E6. doi: 10.3171/2009.12.FOCUS09240.
Resection of lesions involving motor or language areas or pathways requires the intraoperative identification of functional cortical and subcortical sites for effectively and safe guidance. Diffusion tensor (DT) imaging and fiber tractography are MR imaging techniques based on the concept of anisotropic water diffusion in myelinated fibers, which enable 3D reconstruction and visualization of white matter tracts and provide information about the relationship of these tracts to the tumor mass. The authors routinely used DT imaging fiber tractography to reconstruct various tracts involved in the motor and/or language system in a large series of patients with lesions involving the motor and/or language areas or pathways. The DT imaging fiber tractography data were loaded into the neuronavigational system and combined intraoperatively with those obtained from direct electrical stimulation applied at the subcortical level. In this paper the authors report the results of their experience, describing the findings for each tract and discussing technical aspects of the combined use as well as the pitfalls.
切除涉及运动或语言区域或通路的病变需要在术中识别功能皮质和皮质下部位，以有效地和安全地进行指导。弥散张量（DT）成像和纤维束追踪是基于髓鞘纤维各向异性水扩散概念的磁共振成像技术，它能够实现白质束的三维重建和可视化，并提供这些束与肿瘤的关系信息。作者在一系列涉及运动和/或语言区域或通路的病变患者中，常规使用 DT 成像纤维束追踪来重建涉及运动和/或语言系统的各种束。将 DT 成像纤维束追踪数据加载到神经导航系统中，并与在皮质下水平应用直接电刺激获得的数据结合起来在术中使用。本文作者报告了他们的经验结果，描述了每条束的发现，并讨论了联合使用的技术方面以及陷阱。
