Roux F E, Ranjeva J P, Boulanouar K, Manelfe C, Sabatier J, Tremoulet M, Berry I
Department of Neuroradiology, Purpan Hospital, Toulouse, France.
Stereotact Funct Neurosurg. 1997;68(1-4 Pt 1):106-11. doi: 10.1159/000099910.
To evaluate the capabilities and the limitations of motor functional magnetic resonance imaging (fMRI) in the presurgical evaluation of the cerebral tumors located in or near the motor homunculus. To correlate each type of activation with the histologic characteristics of each tumor.
fMRI was performed in 17 patients (14 adults and 3 children), without any motor deficit, presenting with various intracerebral tumors. Three fMRI activation paradigms were used: contralateral to the lesion: ballistic opposition of the fingers, flexion-extension of the foot and click of the tongue. Four patients, without motor deficit, with cerebral tumors far from the motor homunculus were used as control group to look for nonspecific activations. In all cases, the histopathology of the tumor was known accurately.
In 11 patients with infiltrating tumors, the activated areas were clearly displaced. They were often intratumoral and scattered in correlation with the degree of infiltration. Two patients with noninfiltrating tumors (meningioma) showed extratumoral shift of the activated areas. Four patients presenting cerebral tumors far from the homunculus motor did not show intratumoral activation. The supplementary motor area and the ipsilateral primary motor cortex were also reproducibly activated during the motor tasks. The task of the tongue was often artifacted, probably because of the head motion.
These preliminary results suggest that the histopathologic characteristics of a tumor, and especially its microscopic structure, play a role in the organization of the motor functional area. In a small number of cases, fMRI could be used intraoperatively with a neuronavigation system.
评估运动功能磁共振成像（fMRI）在运动小人区或其附近脑肿瘤术前评估中的能力和局限性。将每种激活类型与每种肿瘤的组织学特征相关联。
对17例（14例成人和3例儿童）无任何运动功能缺损的各种脑肿瘤患者进行fMRI检查。使用了三种fMRI激活范式：病变对侧：手指的弹道式对抗、足部的屈伸和舌头的点击。将4例无运动功能缺损、脑肿瘤远离运动小人区的患者作为对照组，以寻找非特异性激活。在所有病例中，肿瘤的组织病理学均准确已知。
在11例浸润性肿瘤患者中，激活区域明显移位。它们常位于肿瘤内，并与浸润程度相关而分散分布。2例非浸润性肿瘤（脑膜瘤）患者的激活区域出现肿瘤外移位。4例脑肿瘤远离运动小人区的患者未显示肿瘤内激活。在运动任务期间，辅助运动区和同侧初级运动皮层也反复被激活。舌头的任务经常出现伪影，可能是由于头部运动所致。
这些初步结果表明，肿瘤的组织病理学特征，尤其是其微观结构，在运动功能区的组织中起作用。在少数情况下，fMRI可在术中与神经导航系统一起使用。
