Division of Neurology, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
Epilepsy Behav. 2013 Oct;29(1):7-12. doi: 10.1016/j.yebeh.2013.06.005. Epub 2013 Aug 1.
Accurate localization of language function is critical in children undergoing epilepsy surgery. Functional magnetic resonance imaging (fMRI) is a noninvasive mapping method that has begun to replace electrocortical stimulation mapping (ESM) and the intracarotid amytal test (IAT). We used both quantitative and qualitative methods to evaluate the concordance of fMRI with ESM and IAT in 20 children using a panel of language tasks. In no cases did fMRI assessment of language hemisphere dominance identify the opposite hemisphere from assessment by IAT or ESM. Concordance with IAT and ESM was higher using fMRI visual inspection than an fMRI laterality index, which failed to lateralize language in a number of the subjects. We have demonstrated that fMRI has good concordance with more traditional methods of language mapping. When fMRI demonstrates bilateral language activations, however, we continue to recommend confirmatory testing by either IAT or ESM prior to resection in classic language regions.
在接受癫痫手术的儿童中，准确定位语言功能至关重要。功能磁共振成像（fMRI）是一种非侵入性的映射方法，已开始替代皮质电刺激映射（ESM）和颈动脉注射戊巴比妥试验（IAT）。我们使用了定量和定性方法，使用语言任务面板评估了 20 名儿童的 fMRI 与 ESM 和 IAT 的一致性。在没有任何情况下，fMRI 评估语言优势半球与 IAT 或 ESM 的评估结果相反。与 IAT 和 ESM 的一致性通过 fMRI 视觉检查比 fMRI 侧化指数更高，在许多受试者中，该指数未能对语言进行侧化。我们已经证明 fMRI 与语言映射的更传统方法具有良好的一致性。然而，当 fMRI 显示双侧语言激活时，我们仍然建议在经典语言区域进行切除之前，通过 IAT 或 ESM 进行确认性测试。
