功能磁共振引导外科切除运动区肿瘤的应用价值

目的：探讨功能磁共振成像（fMRI)诊断脑运动皮层区肿瘤对功能影响程度的准确性和局限性。方法：选择12例脑运动皮层区或附近肿瘤患者，其中脑膜瘤10例，神经上皮肿瘤2例（胶质母细胞瘤和星形细胞瘤各1例），行fMRI检查，在横轴位及冠状位上行运动皮层功能定位，观察相应功能区的形态和分布，以此来指导神经外科手术入路的制定，并对术前和术后功能区进行临床和影像学评价。另选12例正常者作对照。结果：12例正常组均显示了准确的运动皮层中枢形态和位置，其中6例还显示对侧相应的中枢形态。患者组中显示运动皮层中枢的11例，均发生不同程度的移位和变形，12例患者肿瘤被全切除。术后临床和影像学显示：运动功能保存良好。结论：fMRI能准确显示运动皮层中枢位置，对脑肿瘤的手术前方案制定具有重要的指导价值。

Functional magnetic resonance imaging mapping of the motor cortex in patients with cerebral tumors

Objective:To determine the usefulness of functional magnetic resonance imaging (fMRI) of motor cortex in patients with cerebral tumors.Methods: Function MR images of motor cortex were acquired in twelve healthy volunteers and twelve patients with tumors (10 cases meningiomas, 2 cases gliomas) that were located close to or in the precentral gyrus, compared the changes of fMRI maps with pre-operation and post-operation.To study the usefulness of mapping regional brain activity guided surgical treatment planning.Results:The function activation was seen in all volunteers and 11 patients,and a space-occupying lesion can change the cortical representation of motor hand function.Conclusion: The map of motor cortex can be displayed accurately by fMRI and showed usefulness in evaluating the surgical planning.