Mahvash Mehran, Maslehaty Homajoun, Jansen Olav, Mehdorn Hubertus Maximilian, Petridis Athanasios K
Department of Neurosurgery, Clinic of Köln-Merheim, University of Witten-Herdecke, Cologne, Germany.
Department of Neurosurgery, Klinikum Duisburg, Sana Kliniken, Academic Teaching Hospital of University Essen-Duisburg, Germany.
Clin Neurol Neurosurg. 2014 Aug;123:72-7. doi: 10.1016/j.clineuro.2014.05.011. Epub 2014 May 29.
Functional magnetic resonance imaging (fMRI) for motor and language mapping is used for presurgical planning. This study aimed to evaluate the value of fMRI in clinical routine for preoperative planning of brain surgery adjacent to functional brain areas.
Thirty-seven consecutive patients with brain lesions adjacent to sensomotor and/or language functional areas underwent fMRI prior to planned brain surgery on a 3T MRI scanner for identification of motor in all and language functional areas in 29 patients. Analysis software installed on the MRI console was used for rapid image analysis and direct visualization. All fMRI results were analyzed according to the use for preoperative planning.
fMRI data analysis and visualization was possible in less than 10min. In 35 patients fMRI of motor cortex and in 25 patients fMRI of language could be performed due to the patient's compliance. In 34 patients motor activity could be clearly identified in the precentral gyrus. The dominant hemisphere could be identified clearly in 22 cases. In 18 patients direct anatomical correlation of the activity maps to the speech area of Broca and/or Wernicke could be made. Resection surgery was performed in all patients. 11 patients underwent awake surgery with intraoperative cortical stimulation.
fMRI for clinical routine is a reliable and rapid method for identification of functional brain areas prior to brain surgery adjacent to functional areas. This method allows direct monitoring of the data quality and visualization without being time consuming. Knowledge about the relation of functional areas to the brain lesions improves the preoperative planning, the operation strategy and decision making with patients.
用于运动和语言映射的功能磁共振成像（fMRI）被用于术前规划。本研究旨在评估fMRI在临床常规中对邻近脑功能区的脑外科手术术前规划的价值。
37例连续的脑病变邻近感觉运动和/或语言功能区的患者在计划进行脑外科手术前，于3T MRI扫描仪上接受fMRI检查，以识别所有患者的运动功能区以及29例患者的语言功能区。安装在MRI控制台的分析软件用于快速图像分析和直接可视化。所有fMRI结果均根据术前规划用途进行分析。
fMRI数据分析和可视化可在不到10分钟内完成。由于患者的配合，35例患者完成了运动皮层的fMRI检查，25例患者完成了语言的fMRI检查。34例患者在中央前回可清晰识别运动活动。22例患者可清晰识别优势半球。18例患者可将活动图谱与布洛卡区和/或韦尼克区的语言区进行直接解剖关联。所有患者均接受了切除手术。11例患者接受了清醒手术并术中进行皮层刺激。
临床常规使用的fMRI是一种可靠且快速的方法，可用于在邻近功能区的脑外科手术前识别脑功能区。该方法可直接监测数据质量并进行可视化，且不耗时。了解功能区与脑病变的关系可改善术前规划、手术策略以及与患者的决策制定。
