Functional MRI of the brain: localisation of eloquent cortex in focal brain lesion therapy |
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Authors: | S Dymarkowski S Sunaert S Van Oostende P Van Hecke G Wilms P Demaerel B Nuttin C Plets G Marchal |
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Affiliation: | (1) Department of Radiology, University Hospitals, UZ Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium, BE;(2) Department of Neurosurgery, University Hospitals, UZ Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium, BE |
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Abstract: | The aim of this study was to assess the feasibility of functional MRI (fMRI) in a clinical environment on a large patient
group, and to evaluate the pretherapeutic value of localisation of eloquent cortex. Forty patients with focal brain lesions
of different origin were studied using fMRI. Functional information was obtained using motor, somatosensory, auditory and
phonological stimuli depending on the localisation of the lesions. To obtain information about the spatial accuracy of fMRI,
the results were compared with postoperative electrocortical stimulation. Two patients with secondary trigeminal neuralgia
were scanned using a motor protocol and were implanted with an extradural plate electrode. Imaging was successful in 40 of
42 patients (including the 2 with trigeminal neuralgia). These patients were analysed for strength of activation, the relation
of the lesion to activation sites and the presence of mass effect. The correlation between these data and surgical findings
provided significant additional clinical information. Functional MRI can be accurately performed in patients with focal brain
lesions using a dedicated approach. Functional MRI offers important clinical information as a contribution to a decrease in
posttherapeutic morbidity. The accuracy of the technique can be confirmed by other modalities, including invasive cortical
electrostimulation.
Received 19 November 1997; Revision received 23 February 1998; Accepted 3 March 1998 |
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Keywords: | : Functional imaging Brain abnormalities MR studies Neoplasms Image correlation |
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