Sulcus topography of the parietal opercular region: an anatomic and MR study.

The study describes the sulcal and gyral topography, variability, and left-right asymmetry of the parietal operculum. Eighty postmortem hemispheres as well as sagittal magnetic resonance images from 20 health volunteers (40 hemispheres) were evaluated. Four different types of parietal opercular sulcus topography were recognized. Most frequently, and conforming with the anatomic "textbook pattern", the inferior postcentral sulcus (POCS) is the sulcus anterior to the posterior ascending ramus (PAR) of the Sylvian fissure (type 1). Variations were the following: lack of a PAR (type 2), interposition of an intermediate opercular sulcus and gyrus between PAR and POCS (type 3), and direct transition of PAR into POCS with subsequent lack of a classical supramarginal gyrus (type 4). Inconstancy of the sulcal standard arrangement was especially pronounced among left hemispheres, where the patterns differed from type 1 in one third of the cases. Types 2 and 3 were significantly more frequent in left hemispheres, whereas type 4 occurred significantly more frequently in right hemispheres. Upon intraindividual left-right comparison, a remarkable 38% of the brains showed gross asymmetry of the parietal opercular sulcus patterns, characterized by a left type 2 or 3 and/or a right type 4; another 5% exhibited a reverse type of asymmetry. The findings supplement previous data on gross variability and left-right asymmetry of the posterior Sylvian fissure and its lower bank. They indicate that the Sylvian fissure is an unreliable landmark with respect to inferior parietal structures especially in left hemispheres. Individual mapping of perisylvian topography may contribute to studies on structural-functional relationship.