gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Functional magnetic resonance imaging (fMRI) for presurgical motor and language mapping

Funktionelle MRT der Motorik und Sprache zur präoperativen Planung

Meeting Abstract

  • corresponding author M. Mahvash - Klinik für Neurochirurgie, Campus Kiel, Universitätsklinikum Schleswig-Holstein, Kiel, Deutschland
  • N. Warneke - Klinik für Neurochirurgie, Campus Kiel, Universitätsklinikum Schleswig-Holstein, Kiel, Deutschland
  • L. Dörner - Klinik für Neurochirurgie, Campus Kiel, Universitätsklinikum Schleswig-Holstein, Kiel, Deutschland
  • H. M. Mehdorn - Klinik für Neurochirurgie, Campus Kiel, Universitätsklinikum Schleswig-Holstein, Kiel, Deutschland
  • A. Nabavi - Klinik für Neurochirurgie, Campus Kiel, Universitätsklinikum Schleswig-Holstein, Kiel, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocSA.01.04

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2007/07dgnc134.shtml

Veröffentlicht: 11. April 2007

© 2007 Mahvash et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Objective: Functional magnetic resonance imaging (fMRI) for motor and language mapping are used for presurgical planning of resective surgery adjacent to eloquent brain areas. In retrospect we investigate a fast analysis algorithm on a 3-tesla scanner for clinical routine.

Methods: N=34 patients with brain tumors adjacent to eloquent areas underwent fMRI prior to planned resective surgery on a 3-tesla scanner for the identification of the motor area in all and the language areas in 21 of the 34 patients. Analysis software directly installed on the MR console computer was used for image analysis and visualization. The activation maps of fMRI were integrated to T1-weighted anatomical MR images and transferred directly to the operating room for presurgical planning.

Results: In all n=34 patients, motor activity for hand and foot movement could be identified in the precentral gyrus. Because of the cooperation of the patients, FMRI of language could be evaluated in 17 of 21 patients showing significant activity in the dominant hemisphere. In only 11 of them could a direct anatomical correlation of the activity maps to speech area of Broca or Wernicke be made. Resection surgery was performed in all investigated patients using neuronavigation. Seven of them underwent awake surgery with intraoperative cortical stimulation: in one patient cortical stimulation did not correlate with fMRI of motor region. In all patients data analysis and visualization was possible less than 10 minutes using the analysis software directly installed on the MR console computer.

Conclusions: Functional magnetic resonance images (fMRI) with direct fast visual analysis of the images is a useful method for clinical routine and reliable identification of eloquent brain areas prior to surgery. This method allows direct monitoring of the data quality and visualization without being time consuming. FMRI of language can be used for language lateralization but should be used critically for surgical planning. Knowledge about the relation of functional areas to the brain lesions improves the safety during surgery and enhances the surgeon's orientation.