Gallen C C, Sobel D F, Waltz T, Aung M, Copeland B, Schwartz B J, Hirschkoff E C, Bloom F E
Scripps Research Institute, La Jolla, CA.
Neurosurgery. 1993 Aug;33(2):260-8; discussion 268.
Rapid presurgical neuromagnetic localization of the somatosensory cortex was performed successfully on five patients with a large-array biomagnetometer by a protocol called magnetic source imaging (MSI). Determination of the location of the central sulcus is important in assessing operative risk and determining the optimal operative approach to structural lesions in the vicinity of the motor strip. The use of magnetic resonance imaging anatomical methods and intraoperative visual identification can be imprecise, whereas invasive localization prolongs operative time, adds cost, and entails added risk. Until the recent development of large-array biomagnetometer systems, neuromagnetic localization of the central sulcus had been demonstrated in research but was so time consuming and laborious as to preclude routine clinical use. In this study, the validity of MSI localizations was confirmed intraoperatively by direct cortical recording of somatosensory evoked potentials and/or direct motor stimulation. Complete agreement was found between MSI and intraoperative mapping in locating the central sulcus. Objective confirmations considered together with the speed and reliability of the procedure and with the presurgical availability of the results suggests the potential utility of MSI for routine surgical planning.
通过一种称为磁源成像（MSI）的方案，使用大型生物磁强计成功地对5例患者进行了术前体感皮层的快速神经磁定位。确定中央沟的位置对于评估手术风险和确定运动带附近结构性病变的最佳手术入路很重要。使用磁共振成像解剖方法和术中视觉识别可能不准确，而侵入性定位会延长手术时间、增加成本并带来额外风险。在大型生物磁强计系统最近发展之前，中央沟的神经磁定位已在研究中得到证实，但耗时且费力，无法用于常规临床应用。在本研究中，通过体感诱发电位的直接皮层记录和/或直接运动刺激在术中证实了MSI定位的有效性。在定位中央沟方面，MSI与术中图谱完全一致。客观确认结果与该程序的速度和可靠性以及术前可获得结果相结合，表明MSI在常规手术规划中具有潜在用途。
