累及大脑皮层运动区的颅内胶质瘤手术前后功能性磁共振成像

目的：利用功能性磁共振成像原理，对累及大脑皮层运动区的颅内胶质瘤患者进行术前、术后的功能性磁共振成像（fMRI)，即对患者手指运动的皮层定位检查，分辨这些重要的功能皮层区与病变的相邻关系。方法：对15例颅内占位性病变需进行手术治疗的患者，采用血氧依赖水平（BOLD）原理进行扫描，并经计算机处理获得相应的脑功能区的影像表现。结果：所有患者均能在脑功能成像中表现局部功能活动区（相应的手指运动支配功能区）规律的信号－时间变化曲线，以及由于病变造成的皮层功能区的移位和缩小等形态学改变。结论：在常规MR成像后进行功能性MR成像研究，以需实施颅内占位病变，特别是对颅、顶中央沟累及运动皮层的胶质瘤切除术者有十分重要的临床指导意义。

Pre-and Post-Surgical Location and Evaluation of the Motor Hand Area with Functional MR Imaging in Patients with Intracerebral Gliomas

Objective To examine the intracerebral glioma before and after operation by functional MRI with BOLD technique, and to map the brain activation images of the patients on general MR imaging. Methods Fifteen patients had lesions involving the frontal and/or parietal lobs in one side of the cerebral hemispheres, and the lesions included 15 gliomas, MSEPI technique was perfomed with four scan planar parallel AC-PC. During each scan series, the patients were requested to perform repetitive finger-thumb opposition movement in the same period of active and rest duration. All the scanning data were transformed to a work station and dealt with statistical method. The patients had been examined again by the same sequence protocol postoperatively, and the fMRI images were analyzed and compared with that of the preoperation fMRI.Results The motor cortices of both cerebralhemisphere was asymmetrical, and the border between the motor cortex and lesions could be clearly identified in all of the patient preoperatively. After operation, both sites of the motor cortex were nearly replaced.Conclusion fMRI is very useful in evaluation the surgical planning and the prognosis of patients.