Details

Autor(en) / Beteiligte

• Mak, HKF
• Zhang, L
• Feng, ST
• Yeung, DKW
• Chan, DTM
• Zhu, X L
• Poon, W S

Titel

Blood Oxygen Level–Dependent Functional Magnetic Resonance Imaging in Preoperative Brain Mapping and Making Surgical Decisions

Ist Teil von

• Hong Kong journal of radiology : HKJR = Xianggang fang she ke yi xue za zhi, 2011-09, Vol.14 (3), p.147

Ort / Verlag

Hong Kong: Hong Kong Academy of Medicine

Erscheinungsjahr

2011

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• Objective: To evaluate the efficacy of blood oxygen level–dependent functional magnetic resonance imaging in the preoperative mapping of sensorimotor cortices and language areas, and its impact on surgical decisions. Methods: Fourteen patients with tumours or vascular malformations underwent functional magnetic resonance imaging (in the course of motor, sensory, and language tasks) and had structural magnetic resonance imaging scans in a 1.5T scanner. The functional magnetic resonance imaging findings were then correlated with their operative and clinical outcomes. Seven patients had a craniotomy with general anaesthesia, three had awake craniotomy with intraoperative mapping, two had radiosurgery, and two had no surgery. Results: The technical success rate of functional magnetic resonance imaging signal activation in identifying eloquent cortices was 100% for all tasks except Chinese reading, for which the success rate was 83%. Functional magnetic resonance imaging mapping accuracy was determined by correlation with intraoperative cortical stimulation or somatosensory-evoked potentials phase reversal. Surgical decision making was influenced by functional magnetic resonance imaging in 75% of the patients, using a more aggressive approach in two patients and a safer approach in two others (due to lesion proximity of <2 cm from eloquent centres). More conventional craniotomies were performed in five patients due to larger margins (>2 cm) or contralateral location of the language centre. In one patient, there were conflicting results between Wada test and functional magnetic resonance imaging with respect to speech lateralisation; intraoperative cortical stimulation found that functional magnetic resonance imaging correctly predicted the side of speech dominance. Conclusion: Blood oxygen level–dependent functional magnetic resonance imaging had a high technical success rate and was very accurate in mapping eloquent cortical areas preoperatively. Its role in preoperative surgical assessment is pivotal, and is recommended for most, if not all, resective brain surgery.