Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany.
Department of Neuroradiology, University of Erlangen-Nürnberg, Erlangen, Germany.
PLoS One. 2019 Mar 7;14(3):e0213371. doi: 10.1371/journal.pone.0213371. eCollection 2019.
Preoperative functional mapping in the vicinity of brain lesion is of high importance for avoiding complications in surgical management. However, space-occupying lesions may lead to functional reorganization or decreased BOLD activity.
Therefore in 13 patients with cerebral gliomas or brain arterio-venous malformations/ hemangioma fMRI- and MEG-based cortical localizations of motor and somatosensory cortical activation pattern were compared in order to investigate their congruency.
Localization of cortical sensorimotor areas with fMRI and MEG showed good congruency with a mean spatial distance of around 10 mm, with differences depending on the localization method. The smallest mean differences for the centroids were found for MEF with MNE 8 mm and SEF with sLORETA 8 mm. Primary motor area (M1) reorganization was found in 5 of 12 patients in fMRI and confirmed with MEG data. In these 5 patients with M1-reorganization the distance between the border of the fMRI-based cortical M1-localization and the tumor border on T1w MR images varied between 0-4 mm, which was significant (P = 0.025) different to the distance in glioma patients without M1-reorganization (5-26 mm).
Our multimodal preoperative mapping approach combining fMRI and MEG reveals a high degree of spatial congruence and provided high evidence for the presence of motor cortex reorganization.
在靠近脑病变的部位进行术前功能定位对于避免手术管理中的并发症非常重要。然而，占位性病变可能导致功能重组或 BOLD 活性降低。
因此，在 13 名患有脑胶质瘤或脑动静脉畸形/血管瘤的患者中，我们比较了 fMRI 和 MEG 基于皮质的运动和体感皮质激活模式的皮质定位，以研究它们的一致性。
使用 fMRI 和 MEG 定位皮质感觉运动区具有良好的一致性，平均空间距离约为 10mm，定位方法的不同会产生差异。MEF 与 MNE 的中心点差异最小，为 8mm，SEF 与 sLORETA 的中心点差异最小，为 8mm。在 fMRI 中发现 12 例患者中有 5 例存在 M1 重组，并通过 MEG 数据得到证实。在这 5 例 M1 重组患者中，基于 fMRI 的皮质 M1 定位边界与 T1w MR 图像上肿瘤边界之间的距离在 0-4mm 之间变化，这与无 M1 重组的胶质瘤患者（5-26mm）之间的距离存在显著差异（P=0.025）。
我们的结合 fMRI 和 MEG 的多模态术前定位方法显示出高度的空间一致性，并为运动皮质重组的存在提供了有力证据。
