Lau Jonathan C, Kosteniuk Suzanne E, Bihari Frank, Megyesi Joseph F
1Department of Clinical Neurological Sciences (Neurosurgery),Western University,London,Ontario,Canada.
Can J Neurol Sci. 2017 Jan;44(1):59-68. doi: 10.1017/cjn.2016.306.
Functional magnetic resonance imaging (fMRI) is being increasingly used for the preoperative evaluation of patients with brain tumours.
The study is a retrospective chart review investigating the use of clinical fMRI from 2002 through 2013 in the preoperative evaluation of brain tumour patients. Baseline demographic and clinical data were collected. The specific fMRI protocols used for each patient were recorded.
Sixty patients were identified over the 12-year period. The tumour types most commonly investigated were high-grade glioma (World Health Organization grade III or IV), low-grade glioma (World Health Organization grade II), and meningioma. Most common presenting symptoms were seizures (69.6%), language deficits (23.2%), and headache (19.6%). There was a predominance of left hemispheric lesions investigated with fMRI (76.8% vs 23.2% for right). The most commonly involved lobes were frontal (64.3%), temporal (33.9%), parietal (21.4%), and insular (7.1%). The most common fMRI paradigms were language (83.9%), motor (75.0%), sensory (16.1%), and memory (10.7%). The majority of patients ultimately underwent a craniotomy (75.0%), whereas smaller groups underwent stereotactic biopsy (8.9%) and nonsurgical management (16.1%). Time from request for fMRI to actual fMRI acquisition was 3.1±2.3 weeks. Time from fMRI acquisition to intervention was 4.9±5.5 weeks.
We have characterized patient demographics in a retrospective single-surgeon cohort undergoing preoperative clinical fMRI at a Canadian centre. Our experience suggests an acceptable wait time from scan request to scan completion/analysis and from scan to intervention.
功能磁共振成像（fMRI）越来越多地用于脑肿瘤患者的术前评估。
本研究是一项回顾性图表审查，调查了2002年至2013年临床fMRI在脑肿瘤患者术前评估中的应用。收集了基线人口统计学和临床数据。记录了每位患者使用的具体fMRI方案。
在这12年期间共确定了60例患者。最常研究的肿瘤类型是高级别胶质瘤（世界卫生组织III级或IV级）、低级别胶质瘤（世界卫生组织II级）和脑膜瘤。最常见的首发症状是癫痫发作（69.6%）、语言缺陷（23.2%）和头痛（19.6%）。fMRI研究的左侧半球病变占优势（76.8%对右侧的23.2%）。最常受累的脑叶是额叶（64.3%）、颞叶（33.9%）、顶叶（21.4%）和岛叶（7.1%）。最常见的fMRI范式是语言（83.9%）、运动（75.0%）、感觉（16.1%）和记忆（10.7%）。大多数患者最终接受了开颅手术（75.0%），而较小比例的患者接受了立体定向活检（8.9%）和非手术治疗（16.1%）。从申请fMRI到实际进行fMRI采集的时间为3.1±2.3周。从fMRI采集到干预的时间为4.9±5.5周。
我们在一个加拿大中心对接受术前临床fMRI的回顾性单外科医生队列中的患者人口统计学特征进行了描述。我们的经验表明，从扫描申请到扫描完成/分析以及从扫描到干预的等待时间是可以接受的。
