Righini A, de Divitiis O, Prinster A, Spagnoli D, Appollonio I, Bello L, Scifo P, Tomei G, Villani R, Fazio F, Leonardi M
Neuroradiology Department, IRCCS Ospedale Maggiore-Policlinico, Milan, Italy.
J Comput Assist Tomogr. 1996 Sep-Oct;20(5):702-8. doi: 10.1097/00004728-199609000-00003.
Our goal was (a) to test the ability of functional MRI (fMRI) to localize the hand primary motor cortex in patients with brain neoplasms using a conventional scanner and (b) to compare within the same subject the location and morphology of the activated motor areas in the affected hemisphere with the contralateral ones.
Seventeen right-handed patients with frontoparietal intra- and extraaxial tumors were studied. Hand motor performance ranged from normal to slight impairment of finger dexterity. The fMRI study was based on a series of FLASH images. Two or three contiguous slices parallel to the bicommissural plane were acquired through the level of frontoparietal cortex. Each patient was requested to perform with each hand a finger-tapping task or a simpler repetitive flexion-extension of the last four fingers. Pseudo-color activation maps were then calculated by a Z-score method and superimposed on high resolution images.
Five patients were excluded because of gross motion artifacts. In all other patients, areas of significant signal increase were detected on the precentral gyrus. They had a spot-like appearance, and no substantial side-to-side differences in shape or extension could be observed. In the presence of severe compression of the gyri, a displacement of the activated areas in the affected hemisphere with respect to the contralateral ones was noticeable.
fMRI localization of the primary motor area using a conventional scanner can be obtained also in patients with brain tumors, although with a lower success rate than in normal volunteer studies, mainly because of subject compliance problems. Areas of significantly increased signal are detectable even in cortex where normal anatomical patterns are lost.
我们的目标是（a）使用传统扫描仪测试功能磁共振成像（fMRI）在脑肿瘤患者中定位手部初级运动皮层的能力，以及（b）在同一受试者内比较患侧半球与对侧半球激活运动区域的位置和形态。
对17例患有额顶叶轴内和轴外肿瘤的右利手患者进行了研究。手部运动表现从正常到手指灵活性轻微受损不等。fMRI研究基于一系列快速成像（FLASH）图像。通过额顶叶皮层水平获取两到三个与双连合平面平行的连续切片。要求每位患者用每只手执行手指敲击任务或最后四个手指更简单的重复屈伸动作。然后通过Z评分法计算伪彩色激活图，并将其叠加在高分辨率图像上。
5例患者因明显的运动伪影被排除。在所有其他患者中，中央前回检测到信号显著增加的区域。它们呈点状外观，在形状或范围上未观察到明显的左右差异。在脑回严重受压的情况下，患侧半球激活区域相对于对侧半球有明显移位。
使用传统扫描仪对原发性运动区进行fMRI定位在脑肿瘤患者中也可实现，尽管成功率低于正常志愿者研究，主要是由于受试者配合问题。即使在正常解剖模式消失的皮层中也能检测到信号显著增加的区域。
