Dymarkowski S, Sunaert S, Van Oostende S, Van Hecke P, Wilms G, Demaerel P, Nuttin B, Plets C, Marchal G
Department of Radiology, University Hospitals, Leuven, Belgium.
Eur Radiol. 1998;8(9):1573-80. doi: 10.1007/s003300050589.
The aim of this study was to assess the feasibility of functional MRI (fMRI) in a clinical environment on a large patient group, and to evaluate the pretherapeutic value of localisation of eloquent cortex. Forty patients with focal brain lesions of different origin were studied using fMRI. Functional information was obtained using motor, somatosensory, auditory and phonological stimuli depending on the localisation of the lesions. To obtain information about the spatial accuracy of fMRI, the results were compared with postoperative electrocortical stimulation. Two patients with secondary trigeminal neuralgia were scanned using a motor protocol and were implanted with an extradural plate electrode. Imaging was successful in 40 of 42 patients (including the 2 with trigeminal neuralgia). These patients were analysed for strength of activation, the relation of the lesion to activation sites and the presence of mass effect. The correlation between these data and surgical findings provided significant additional clinical information. Functional MRI can be accurately performed in patients with focal brain lesions using a dedicated approach. Functional MRI offers important clinical information as a contribution to a decrease in posttherapeutic morbidity. The accuracy of the technique can be confirmed by other modalities, including invasive cortical electrostimulation.
本研究的目的是评估在临床环境中对大量患者群体进行功能磁共振成像（fMRI）的可行性，并评估明确皮层定位的治疗前价值。使用fMRI对40例不同病因的局灶性脑损伤患者进行了研究。根据损伤的定位，使用运动、躯体感觉、听觉和语音刺激来获取功能信息。为了获得有关fMRI空间准确性的信息，将结果与术后皮层电刺激进行了比较。对2例继发性三叉神经痛患者采用运动方案进行扫描，并植入硬膜外板电极。42例患者中有40例（包括2例三叉神经痛患者）成像成功。对这些患者的激活强度、损伤与激活部位的关系以及是否存在占位效应进行了分析。这些数据与手术结果之间的相关性提供了重要的额外临床信息。使用专门的方法，可以在局灶性脑损伤患者中准确地进行功能磁共振成像。功能磁共振成像提供了重要的临床信息，有助于降低治疗后发病率。该技术的准确性可以通过其他方式得到证实，包括侵入性皮层电刺激。
