Institute of Neuroradiology, University Hospital, Goethe University Frankfurt, D-60528 Frankfurt am Main, Germany.
AJNR Am J Neuroradiol. 2013 Feb;34(2):323-6. doi: 10.3174/ajnr.A3205. Epub 2012 Jul 19.
Identification of the central region is of special importance to avoid neurologic deficits in brain surgery. Brain surface reformatted images (Mercator view) map the frontoparietal brain surface in 1 view and provide a synopsis of the most important landmarks. In this view, the U-shaped subcentral gyrus appears as a distinctive anatomic structure enclosing the Sylvian end of the central sulcus. The purpose of this study was to add the subcentral gyrus as a new landmark to the central region (U sign) and to compare its frequency and applicability with common landmarks in healthy hemispheres.
Mercator views of 178 hemispheres in 100 patients were generated from 3D MR imaging datasets. The hemispheres were evaluated on Mercator views for the presence or absence of each of the 9 common landmarks and the new U sign identifying the central region.
The new landmark U sign was most common (96.6%), followed by the thin postcentral gyrus sign (95.5%). The least common landmark was the Ω-shaped handknob (54.5%). None of the landmarks could be identified in all hemispheres. All landmarks could be identified bilaterally in only 1.3% of patients.
On the Mercator view, the new U sign is an applicable and even the most frequent landmark to identify the central region. Considering the variability of the anatomic structures of the brain, including the motor hand area, the synopsis of all 10 landmarks on this surface-reformatting projection is a helpful adjunct to standard MR imaging projections to identify the central region.
在脑外科手术中，识别中央区域尤为重要，可避免神经功能缺损。脑表面重建成像（麦卡托视图）在 1 个视图中映射额顶叶脑表面，并提供最重要标志的概述。在该视图中，U 形中央旁回表现为一个独特的解剖结构，环绕中央沟的 Sylvian 末端。本研究旨在将中央旁回作为新标志添加到中央区域（U 征），并与健康半球的常见标志比较其频率和适用性。
从 100 例患者的 3D MRI 数据集生成了 178 个半球的麦卡托视图。在麦卡托视图上评估半球是否存在 9 个常见标志和新的 U 征（用于识别中央区域）中的每一个标志。
新标志 U 征最常见（96.6%），其次是薄后中央回征（95.5%）。最不常见的标志是Ω形手把（54.5%）。没有一个标志可以在所有半球上识别。所有标志仅在 1.3%的患者中可以双侧识别。
在麦卡托视图上，新的 U 征是一种适用的标志，甚至是识别中央区域最常见的标志。考虑到脑的解剖结构的可变性，包括运动手区，在该表面重建成像上对所有 10 个标志的综述是识别中央区域的标准磁共振成像投影的有用补充。
