Boerwinkle Varina L, Vedantam Aditya, Lam Sandi, Wilfong Angus A, Curry Daniel J
Department of Pediatric Neurology, Phoenix Children's Hospital, Barrow Neurological Institute, 1919 E. Thomas Rd, Ambulatory Bld 3, Phoenix, AZ, USA.
Department of Pediatric Neurosurgery, Texas Children's Hospital, Baylor College of Medicine, 6701 Fannin St. CC1230, Houston, TX, USA.
Epilepsy Res. 2018 May;142:156-160. doi: 10.1016/j.eplepsyres.2017.09.015. Epub 2017 Sep 28.
Resting-state functional magnetic resonance imaging (rsfMRI) is emerging as a useful tool in the multimodal assessment of patients with epilepsy. In pediatric patients who cannot perform task-based fMRI, rsfMRI may present an adjunct and alternative. Although changes in brain activation during task-based fMRI have been described after surgery for epilepsy, there is limited data on the role of postoperative rsfMRI. In this short review, we discuss the role of postoperative rsfMRI after laser ablation of seizure foci. By establishing standardized anesthesia protocols and imaging parameters, we have been able to perform serial rsfMRI at postoperative follow-up. The development of in-house software that can merge rsfMRI images to surgical navigation systems has allowed us to enhance the clinical applications of this technique. Resting-state fMRI after laser ablation has the potential to identify changes in connectivity, localize new seizure foci, and guide antiepileptic therapy. In our experience, rsfMRI complements conventional MR imaging and task-based fMRI for the evaluation of patients with seizure recurrence after laser ablation, and represents a potential noninvasive biomarker for functional connectivity.
静息态功能磁共振成像（rsfMRI）正在成为癫痫患者多模态评估中的一种有用工具。在无法进行基于任务的功能磁共振成像的儿科患者中，rsfMRI可能是一种辅助和替代方法。虽然癫痫手术后基于任务的功能磁共振成像期间的脑激活变化已有描述，但关于术后rsfMRI作用的数据有限。在这篇简短综述中，我们讨论癫痫病灶激光消融术后rsfMRI的作用。通过建立标准化的麻醉方案和成像参数，我们得以在术后随访时进行系列rsfMRI检查。能够将rsfMRI图像与手术导航系统合并的内部软件的开发，使我们能够增强该技术的临床应用。激光消融后的静息态功能磁共振成像有潜力识别连接性变化、定位新的癫痫病灶并指导抗癫痫治疗。根据我们的经验，rsfMRI在评估激光消融术后癫痫复发患者时可补充传统磁共振成像和基于任务的功能磁共振成像，并且是功能连接性的一种潜在非侵入性生物标志物。
