OBJECTIVE: To demonstrate the accuracy of magnetic resonance tractograpghy (MRT) in localizing the cortical spinal tract (CST) close to brain tumours by using intraoperative electric subcortical stimulation. METHODS: Nine patients with intra-axial brain tumours underwent neurosurgery. Planning was based on analysis of the course of streamlines compatible with the CST. After tumour removal, intraoperative MRT was reacquired. Sites at various distance from the CST were repeatedly stimulated to assess whether registered motor evoked potential (MEP) could be elicited. All patients were assessed clinically both pre- and postoperatively. RESULTS: The motor function was preserved in all patients. In all patients intraoperative MRT demonstrated shift of the bundle position caused by the surgical procedure. The distance between the estimated intraoperative CST and the point of elicited MEP was 1 cm or less in all nine patients. At distances greater than 2 cm, no patient reported positive MEP. CONCLUSION: Intraoperative MRT is a reliable technique for localization of CST. In all patients MEP were elicited by direct subcortical electrical stimulation at a distance below 1 cm from the CST as represented by MRT. Brain shifting might impact this evaluation since CST position may change during surgery in the range of 8 mm.
OBJECTIVE: To demonstrate the accuracy of magnetic resonance tractograpghy (MRT) in localizing the cortical spinal tract (CST) close to brain tumours by using intraoperative electric subcortical stimulation. METHODS: Nine patients with intra-axial brain tumours underwent neurosurgery. Planning was based on analysis of the course of streamlines compatible with the CST. After tumour removal, intraoperative MRT was reacquired. Sites at various distance from the CST were repeatedly stimulated to assess whether registered motor evoked potential (MEP) could be elicited. All patients were assessed clinically both pre- and postoperatively. RESULTS: The motor function was preserved in all patients. In all patients intraoperative MRT demonstrated shift of the bundle position caused by the surgical procedure. The distance between the estimated intraoperative CST and the point of elicited MEP was 1 cm or less in all nine patients. At distances greater than 2 cm, no patient reported positive MEP. CONCLUSION: Intraoperative MRT is a reliable technique for localization of CST. In all patients MEP were elicited by direct subcortical electrical stimulation at a distance below 1 cm from the CST as represented by MRT. Brain shifting might impact this evaluation since CST position may change during surgery in the range of 8 mm.
Authors: B Stieltjes; W E Kaufmann; P C van Zijl; K Fredericksen; G D Pearlson; M Solaiyappan; S Mori Journal: Neuroimage Date: 2001-09 Impact factor: 6.556
Authors: A Romano; M Ferrante; V Cipriani; F Fasoli; L Ferrante; G D'Andrea; L M Fantozzi; A Bozzao Journal: Radiol Med Date: 2007-09-20 Impact factor: 3.469
Authors: Lorenzo Bello; Anna Gambini; Antonella Castellano; Giorgio Carrabba; Francesco Acerbi; Enrica Fava; Carlo Giussani; Marcello Cadioli; Valeria Blasi; Alessandra Casarotti; Costanza Papagno; Arun K Gupta; Sergio Gaini; Giuseppe Scotti; Andrea Falini Journal: Neuroimage Date: 2007-08-29 Impact factor: 6.556