Conti Nibali Marco, Rossi Marco, Sciortino Tommaso, Riva Marco, Gay Lorenzo G, Pessina Federico, Bello Lorenzo
Unit of Neurosurgical Oncology, Department of Oncology and Hemato-Oncology, Humanitas Research Hospital, IRCCS, University of Milan, Milan, Italy -
Unit of Neurosurgical Oncology, Department of Oncology and Hemato-Oncology, Humanitas Research Hospital, IRCCS, University of Milan, Milan, Italy.
J Neurosurg Sci. 2019 Apr;63(2):127-134. doi: 10.23736/S0390-5616.18.04597-6. Epub 2018 Oct 2.
Brain mapping techniques (intraoperative neurophysiology and neuropsychology) represent the gold standard in glioma surgery, and particularly in glioma resection. Since the introduction of MRI in the clinical practice, several advanced applications have been developed, like functional MRI (fMRI) and diffusion imaging-based tractography (DTI), which both have an application in glioma surgery. fMRI allows to identify cortical areas related to a specific function, DTI allows to reconstruct a model of the sub-cortical connectivity. This paper describes the clinical application of fMRI and DTI, enlightening sensitivity and specificity in comparison to gold standard and underlining their limitations in surgical decision making.
脑图谱技术（术中神经生理学和神经心理学）是胶质瘤手术尤其是胶质瘤切除术中的金标准。自从MRI引入临床实践以来，已经开发了几种先进的应用，如功能磁共振成像（fMRI）和基于扩散成像的纤维束成像（DTI），它们在胶质瘤手术中都有应用。fMRI能够识别与特定功能相关的皮质区域，DTI能够重建皮质下连接模型。本文描述了fMRI和DTI的临床应用，与金标准相比阐明了其敏感性和特异性，并强调了它们在手术决策中的局限性。
