TY - JOUR
T1 - Identification of the sensorimotor cortex with functional MRI
T2 - Frequency and actual contribution in a neurosurgical context
AU - Pujol, Jesus
AU - Deus, Joan
AU - Acebes, Juan J.
AU - Villanueva, Alicia
AU - Aparicio, Alberto
AU - Soriano-Mas, Carles
AU - Ortiz, Hector
AU - Conesa, Gerardo
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2008/1
Y1 - 2008/1
N2 - BACKGROUND AND PURPOSE: We assessed the actual frequency of motor functional MRI (fMRI) in a neurosurgical environment and estimated the extent to which it aided surgeons' identifications of the sensorimotor cortex. METHODS: During five consecutive years, an fMRI protocol aimed at generating a selective activation of the hand cortical area was prescribed to 147 patients showing a centrally located space-occupying lesion, which represents 6.7% of all assisted surgical candidates showing an intracranial mass. Three senior neurosurgeons indicated the position of the sensorimotor cortex on two different anatomical displays, reporting confidence ratings for each decision. RESULTS: The sensorimotor cortex could not be identified in 16.5% of cases using conventional anatomical MRI, and in 15% of cases using 3-dimensional reconstructions. In an additional 12.5% of cases, the neurosurgeons were not confident when they correctly identified the sensorimotor cortex. The tumor distorting effect on central region anatomy significantly contributed to sensorimotor cortex misidentification. fMRI, by contrast, showed a selective activation indicating the position of the sensorimotor cortex in all but 4% of cases. CONCLUSIONS: In our neurosurgical environment, fMRI was prescribed to a selected group of surgical candidates showing a centrally located brain lesion. Compared to conventional anatomical imaging, fMRI does appear to improve the identification of sensorimotor cortex.
AB - BACKGROUND AND PURPOSE: We assessed the actual frequency of motor functional MRI (fMRI) in a neurosurgical environment and estimated the extent to which it aided surgeons' identifications of the sensorimotor cortex. METHODS: During five consecutive years, an fMRI protocol aimed at generating a selective activation of the hand cortical area was prescribed to 147 patients showing a centrally located space-occupying lesion, which represents 6.7% of all assisted surgical candidates showing an intracranial mass. Three senior neurosurgeons indicated the position of the sensorimotor cortex on two different anatomical displays, reporting confidence ratings for each decision. RESULTS: The sensorimotor cortex could not be identified in 16.5% of cases using conventional anatomical MRI, and in 15% of cases using 3-dimensional reconstructions. In an additional 12.5% of cases, the neurosurgeons were not confident when they correctly identified the sensorimotor cortex. The tumor distorting effect on central region anatomy significantly contributed to sensorimotor cortex misidentification. fMRI, by contrast, showed a selective activation indicating the position of the sensorimotor cortex in all but 4% of cases. CONCLUSIONS: In our neurosurgical environment, fMRI was prescribed to a selected group of surgical candidates showing a centrally located brain lesion. Compared to conventional anatomical imaging, fMRI does appear to improve the identification of sensorimotor cortex.
KW - Brain tumors
KW - Functional MRI
KW - Sensorimotor cortex
UR - http://www.scopus.com/inward/record.url?scp=38049095788&partnerID=8YFLogxK
U2 - 10.1111/j.1552-6569.2007.00175.x
DO - 10.1111/j.1552-6569.2007.00175.x
M3 - Artículo
C2 - 18190492
AN - SCOPUS:38049095788
VL - 18
SP - 28
EP - 33
JO - Journal of Neuroimaging
JF - Journal of Neuroimaging
SN - 1051-2284
IS - 1
ER -