Kim Joon-Hyung, Amankulor Nduka M, Peck Kyung K, Brennan Nicole, Gutin Philip H, Holodny Andrei I
a Department of Neurosurgery , Memorial Sloan-Kettering Cancer Center , New York , NY , USA.
Neurocase. 2014;20(5):481-6. doi: 10.1080/13554794.2013.826678. Epub 2013 Aug 13.
Gross total resection of gliomas can be limited by the involvement of tumor in eloquent areas. Moreover, lesions can impart cortical reorganization and make the precise determination of hemispheric dominance and localization of language function even more difficult. Preoperative mapping with functional magnetic resonance imaging (fMRI), intraoperative imaging modalities, and intraoperative direct cortical stimulation enable surgeons to map the functional topography of the brain in relation to the tumor and perform a safe maximal resection. In this report, we present a patient with left frontal glioma of complex morphology, wherein the tumor was enveloped by Broca's area on fMRI. Intraoperative mapping and intraoperative magnetic resonance imaging (iMRI) allowed gross total resection of the tumor with preservation of language function and illustrate the utility of multiple contemporary modalities in the surgical management of low-grade gliomas located in eloquent cortices.
胶质瘤的全切除可能会受到肿瘤累及功能区的限制。此外，病变可导致皮质重组，使得半球优势的精确判定和语言功能定位变得更加困难。术前通过功能磁共振成像（fMRI）、术中成像方式以及术中直接皮质刺激，外科医生能够描绘出与肿瘤相关的脑功能地形图，并进行安全的最大程度切除。在本报告中，我们展示了一名患有形态复杂的左额叶胶质瘤的患者，其肿瘤在fMRI上被布洛卡区包绕。术中绘图和术中磁共振成像（iMRI）使得肿瘤得以全切除且语言功能得以保留，这说明了多种现代方法在位于功能区皮质的低级别胶质瘤手术治疗中的实用性。
