Beijing Neurosurgical Institute, Capital Medical University, 6, Tiantanxili, 100050, Beijing, China.
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Clin Neuroradiol. 2019 Jun;29(2):243-251. doi: 10.1007/s00062-017-0659-8. Epub 2018 Jan 9.
The hand knob area is the cortical representation of motor hand function. The current study aimed to investigate the effects of eloquent area gliomas on the morphometry of the hand motor cortex and preoperative hand motor function.
A retrospective study of 320 glioma patients was conducted. Seventy-eight patients with gliomas involving motor functional area were finally enrolled. Using axial T2-weight magnetic resonance images, the width and height of the hand knob were measured in both hemispheres, and differences were compared between the affected and unaffected hemispheres. Receiver operating characteristic (ROC) curve and logistic regression analysis were used to estimate the degree of correlation between distance measurements and motor impairment.
The width and height of the hand knob in the affected and unaffected hemispheres were significantly different (p < 0.0001). The width, height and distance from the tumor to hand knob were reduced in the functionally impaired group compared to the unimpaired group (p = 0.0003, p < 0.0001, p = 0.0005, respectively). The three parameters were significantly correlated and remained significant in ROC and logistic regression analysis. The optimal cut-off value of width, height and distance for identifying preoperative hand muscle strength were 5.73 mm, 5.80 mm and 5.92 mm, respectively.
The morphometry of the hand knob is often changed by the infiltration or extrusion of the tumors that were located in or near the hand knob. The width, height of hand knob and the distance from tumor to hand knob could serve as anatomic biomarkers related to preoperative neurological motor deficits.
手 knob 区是手部运动功能的皮质代表区。本研究旨在探讨语言区胶质瘤对手部运动皮质形态和术前手部运动功能的影响。
对 320 例胶质瘤患者进行回顾性研究，最终纳入 78 例累及运动功能区的胶质瘤患者。使用轴位 T2 加权磁共振图像，测量双侧半球手 knob 的宽度和高度，并比较受累侧和未受累侧之间的差异。采用受试者工作特征（ROC）曲线和逻辑回归分析评估距离测量与运动障碍的相关性程度。
受累侧和未受累侧手 knob 的宽度和高度差异均有统计学意义（p < 0.0001）。与未受损组相比，功能受损组的手 knob 宽度、高度和距离肿瘤的距离均减小（p = 0.0003、p < 0.0001、p = 0.0005）。这三个参数之间呈显著相关，ROC 和逻辑回归分析仍具有统计学意义。用于识别术前手部肌肉力量的宽度、高度和距离的最佳截断值分别为 5.73 mm、5.80 mm 和 5.92 mm。
肿瘤位于手 knob 区或附近时，手 knob 的形态通常会发生改变。手 knob 的宽度、高度和距离肿瘤的距离可作为与术前神经运动缺陷相关的解剖学生物标志物。
