Black David F, Little Jason T, Johnson Derek R
Mayo Clinic - Radiology, Rochester, MN.
Top Magn Reson Imaging. 2019 Aug;28(4):213-224. doi: 10.1097/RMR.0000000000000213.
Task-based functional magnetic resonance imaging (fMRI) for the presurgical assessment of eloquent cortex is increasingly relied upon by surgeons, neurologists, and radiologists. The utility of fMRI stems from the lack of correlation between topographic anatomy and functional anatomy. fMRI can noninvasively reveal the functional anatomy of a given individual thereby allowing the surgeon to choose the most appropriate surgical trajectory, attain the most complete resection, and offer the best chance of preserving function. This dissociation between function and topography is even more critical to understand when disease distorts normal anatomic relations and when chronic evolution of pathology leads to reorganization of cortical function as can be seen with seizures or slow growing tumors. fMRI can demonstrate the functional anatomy of language, motor, vision, and memory systems. Accurate interpretation not only requires knowledge of the expected patterns of activations in the regions of interest but also demands an understanding of the many adjacent "bystander" activations that represent participatory neural activity but not the eloquent region in question. In addition, fMRI interpretation requires an understanding of the limitations of this technique when expected activity is either missing or seemingly displaced in location.
基于任务的功能磁共振成像（fMRI）用于术前明确脑功能区皮层，越来越受到外科医生、神经科医生和放射科医生的依赖。fMRI的效用源于局部解剖结构与功能解剖结构之间缺乏相关性。fMRI可以无创地揭示特定个体的功能解剖结构，从而使外科医生能够选择最合适的手术路径，实现最完整的切除，并提供保留功能的最佳机会。当疾病扭曲正常解剖关系，以及病理的慢性演变导致皮质功能重组时，如癫痫或生长缓慢的肿瘤所见，功能与局部解剖之间的这种分离对于理解更为关键。fMRI可以显示语言、运动、视觉和记忆系统的功能解剖结构。准确的解读不仅需要了解感兴趣区域预期的激活模式，还需要理解许多相邻的“旁观者”激活，这些激活代表参与性神经活动，但不是所讨论的明确区域。此外，当预期活动缺失或位置看似移位时，fMRI解读需要理解该技术的局限性。
