脑肿瘤患者术前手运动区的功能MRI

目的：探讨应用功能ＭＲＩ（ｆＭＲＩ）研究脑肿瘤患者手运动区（ＨＲＡ）的结构和功能变化特征。材料和方法：２２例位于或邻近实级运动皮质肿瘤患者采用单次激发ＧＲＥ－ＥＰＩ序列采集Ｔ＾＊２Ｗ图像，共３个周期即６个时相，每个周期包括手指对掌运动激发的１０幅活动图像和１０幅静止图像。经离线工作站重建获取减影后的差别图像，设定ＲＯＩ，描绘动态时间－信号强度曲线，测量信号强度（ＳＩ）上升百分率。结果：８例ＨＲＡ呈局限分布，１４例呈弥漫分布。肿瘤实体的边缘与ＨＲＡ活动中心的最短距离为０．３￣２．８ｃｍ。有５例患者在肿瘤内见到高信号区。肿瘤侧ＳＩ上升百分率为１．５％￣３％，正常侧ＳＩ上升百分率为２．５％￣１０％，结论：对位于或邻近初级运动皮质脑肿瘤患者，功能ＭＲＩ为术前手术计划的制定提供了一种非侵袭性而有效的方法。如果肿瘤实体的边

Presurgical Evaluation of Motor Hand Representation Area with Functional MRI in Patients with Brain Tumor

Purpose: To investigate the role of functional MR imaging(fMRI) in depiction of the motor hand representation area(HRA) in patients with brain tumor. Materials and methods: Single shot GRE - EPI MR imaging(T2 ＊ WI images) was performed in 22 cases with brain tumor in or close to the primary motor cortex. Three series of ten activation images(obtained while pateint performed repetitive finger - to thumb opposition movements ) and ten rest images were acquired. The data of activation and rest images were reconstructed with an offine workstation. Difference maps were obtained with simple subtraction between activation and rest images. The time - signal curve of the region of interest was plotted, and the percentage of signal rising was calculated. Results: The HRA was revealed locally and diffusely distributed in 8 and 14 cases respectively. The shortest distance between the HRA and the tumor margin was 3%～28mm. High signals were found inside the tumor area in 5 cases. The percentage of signal rising was 1.5%～3.0% in the hemisphere with tumor, and was 2.5%～10% in the hemisphere without tumor.Conclusion: In patients with brain tumor in or close to the primary motor cortex, fMRI is a useful noninvasive procedure for a better - prepared surgical approach and better patient information. If the distance between the center of HRA and the tumor margin is larger than 2cm, the hand movement may remain unharmed post - surgically.