title: The central sulcal vein: a landmark for identification of the central sulcus using functional magnetic resonance imaging.
abstract: The authors evaluated the anatomical location of the central sulcus (CS) in 24 cerebral hemispheres (eight in which tumors were located centrally, 16 in controls) using: 1) classic anatomical landmarks seen on magnetic resonance (MR) imaging (24 hemispheres); 2) functional MR imaging (24 hemispheres); and 3) intraoperative electrical stimulation mapping (eight hemispheres). On MR imaging the CS was identified with certainty in 79% of hemispheres (four of eight in patients, 15 of 16 in controls). Functional MR imaging identified a parenchymal "motor hand area" in only 83% (20 of 24 hemispheres; five of eight in patients, 15 of 16 in controls); this area was located in the precentral gyrus in 16 (80%) of 20, additionally in the postcentral gyrus in 10 (50%) of 20, and exclusively in the postcentral gyrus in four (20%) of 20. In contrast, functional MR imaging detected one to three sulcal veins presumably draining blood from the adjacent motor hand area in 100% (24 of 24) of the hemispheres studied, and anatomical MR imaging and intraoperative mapping localized these veins in the CS. It is concluded that sulcal veins lying deep within the CS: 1) drain activated blood from the adjacent pre- or postcentral cortex during performance of a motor hand task; 2) can be identified easily with functional MR imaging; and 3) are an anatomical landmark for noninvasive identification of the CS and thus the sensorimotor strip. The detection of these veins provides a more consistent landmark than the detection of parenchymal motor areas by functional MR imaging; this technique may be used when classic anatomical landmarks fail to identify the sensorimotor strip.
authors.affiliation: Department of Neuroradiology, Klinikum Grosshadern, Ludwig Maximilian University, Munich, Germany.
authors.forename: T A
authors.initials: TA
authors.lastname: Yousry
authors.forename: U D
authors.initials: UD
authors.lastname: Schmid
authors.forename: D
authors.initials: D
authors.lastname: Schmidt
authors.forename: T
authors.initials: T
authors.lastname: Hagen
authors.forename: A
authors.initials: A
authors.lastname: Jassoy
authors.forename: M F
authors.initials: MF
authors.lastname: Reiser
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000473:pathology; D002540:Cerebral Cortex / Q000473:pathology*; D002550:Cerebral Veins / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged