OBJECT: The authors sought to evaluate the advantages and limitations of functional magnetic resonance (fMR) imaging when it was used regularly in the clinical context to identify the central sulcus. METHODS: A 1.5-tesla MR system comprising a spoiled gradient recalled acquisition in the steady-state functional sequence and a cross-hand cancellation analysis method were used to evaluate 50 surgical candidates with centrally located space-occupying lesions in the brain. Three-dimensional (3-D) models of the patient's head and brain showing the relative position of the tumor and the eloquent cortex were obtained in each case. A selective and reproducible focal activation was found, indicating the probable central sulcus position in 41 patients (82%). Direct cortical stimulation confirmed the fMR findings in 100% of 22 intraoperatively assessed patients. Failure to identify the central sulcus occurred in 18% of cases and was mainly a consequence of intrinsic damage in the primary sensorimotor region that resulted in severe hand paresis. CONCLUSIONS: Although specific factors were identified that contributed to reduced sensitivity of fMR imaging in the clinical context, the present study supports functional assessment and 3-D representation of specific surgical situations as generally feasible in common practice.
OBJECT: The authors sought to evaluate the advantages and limitations of functional magnetic resonance (fMR) imaging when it was used regularly in the clinical context to identify the central sulcus. METHODS: A 1.5-tesla MR system comprising a spoiled gradient recalled acquisition in the steady-state functional sequence and a cross-hand cancellation analysis method were used to evaluate 50 surgical candidates with centrally located space-occupying lesions in the brain. Three-dimensional (3-D) models of the patient's head and brain showing the relative position of the tumor and the eloquent cortex were obtained in each case. A selective and reproducible focal activation was found, indicating the probable central sulcus position in 41 patients (82%). Direct cortical stimulation confirmed the fMR findings in 100% of 22 intraoperatively assessed patients. Failure to identify the central sulcus occurred in 18% of cases and was mainly a consequence of intrinsic damage in the primary sensorimotor region that resulted in severe hand paresis. CONCLUSIONS: Although specific factors were identified that contributed to reduced sensitivity of fMR imaging in the clinical context, the present study supports functional assessment and 3-D representation of specific surgical situations as generally feasible in common practice.
Authors: C C Lee; H A Ward; F W Sharbrough; F B Meyer; W R Marsh; C Raffel; E L So; G D Cascino; C Shin; Y Xu; S J Riederer; C R Jack Journal: AJNR Am J Neuroradiol Date: 1999-09 Impact factor: 3.825
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Authors: T Krings; M H Reinges; S Erberich; S Kemeny; V Rohde; U Spetzger; M Korinth; K Willmes; J M Gilsbach; A Thron Journal: J Neurol Neurosurg Psychiatry Date: 2001-06 Impact factor: 10.154
Authors: G Fesl; M Demmel; J Albrecht; R Kopietz; V Schoepf; A M Kleemann; O Pollatos; A Anzinger; T Schreder; H Brueckmann; M Wiesmann Journal: Clin Neuroradiol Date: 2010-08-05 Impact factor: 3.649
Authors: Dongyang Zhang; James M Johnston; Michael D Fox; Eric C Leuthardt; Robert L Grubb; Michael R Chicoine; Matthew D Smyth; Abraham Z Snyder; Marcus E Raichle; Joshua S Shimony Journal: Neurosurgery Date: 2009-12 Impact factor: 4.654