gms | German Medical Science

73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

Passive sensorimotor intraoperative functional 3T-MRI for brain mapping and neuronavigation under general anesthesia – first experience with 6 patients

Intraoperatives 3T-fMRT für Brain-Mapping und Neuronavigation mithilfe passiver sensomotorischer Stimuli unter Vollnarkose – erste Erfahrungen mit 6 Patienten

Meeting Abstract

  • presenting/speaker Jonathan Wais - Medizinische Universität Wien, Universitätsklinik für Neurochirurgie, Wien, Österreich
  • Gregor Kasprian - Medizinische Universität Wien, Department of Biomedical Imaging and Image-guided Therapy, Wien, Österreich
  • Christian Dorfer - Medizinische Universität Wien, Universitätsklinik für Neurochirurgie, Wien, Österreich
  • Gilbert Hangl - Medizinische Universität Wien, Universitätsklinik für Neurochirurgie & High Field MR Centre, Wien, Österreich
  • Matthias Tomschik - Medizinische Universität Wien, Universitätsklinik für Neurochirurgie, Wien, Österreich
  • Philipp Pruckner - Medizinische Universität Wien, Department of Biomedical Imaging and Image-guided Therapy, Wien, Österreich
  • Karl Rössler - Medizinische Universität Wien, Universitätsklinik für Neurochirurgie, Wien, Österreich

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocP165

doi: 10.3205/22dgnc477, urn:nbn:de:0183-22dgnc4775

Veröffentlicht: 25. Mai 2022

© 2022 Wais et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: Functional MRI (fMRI) is widely accepted as a reliable tool for brain mapping due to its high spatial resolution, which is particularly useful for neuronavigation. Previous studies have shown that results of passive motor fMRI during anesthesia are relevant and helpful for identification of the primary sensorimotor cortex. Here we demonstrate our first experience in using intraoperative fMRI (ifMRI) under general anesthesia for on-site brain mapping using passive sensorimotor stimuli.

Methods: Six patients underwent tumor-resection involving the primary motor cortex with guidance using intraoperative imaging, neuronavigation and electrophysiological neuromonitoring. Pre- and postoperative 3T fMRI was performed using a block design (finger tapping, ankle motion) motor paradigm (BOLD Sequence, TR=1000ms, voxel size 2.5x2.5x2.5mm). In addition, intraoperative 3T MRI using structural T1 and T2-weighted sequences as well as ifMRI (BOLD Sequence, TR=2000 - 4000ms, voxel size 3x3x3mm) using passive sensorimotor stimuli under general anesthesia were performed before and after gross resection. The acquired data was correlated and validated by intraoperative motor cortex stimulation (MCS) and presurgical planning fMRI data.

Results: Passive intraoperative sensorimotor ifMRI showed unequivocal activations centered in the primary sensory and motor cortices during preoperative scanning under general anesthesia. After gross tumor resection, activations consistent with sensory activations in the appropriate and expected anatomical regions could be detected. MCS validated the motor foci defined by ifMRI imaging in all six cases. No complications occurred during ifMRI passive sensorimotor stimulation.

Conclusion: We present a technique for intraoperative on-site mapping of the sensorimotor cortices for intraoperative neuronavigation using passive sensorimotor stimuli in an ifMRI setting, which can be performed safely, fast and on patients, who otherwise would not be able to perform fMRI tasks sufficiently. Further studies on validity considering intraoperative distortion artifacts and systematic postoperative functional outcomes are needed.