fMRI for preoperative neurosurgical mapping of motor cortex and language in a clinical setting.
OBJECTIVE
Identification of the precentral gyrus can be difficult in patients with brain tumors. The purpose of the current study was to evaluate the clinical usefulness of functional MRI (fMRI) in identifying motor cortex and speech areas as a part of preoperative neurosurgical planning.


METHODS
fMRI was performed using a 1.5 T MR unit in 41 patients with brain tumors. The motor paradigm was finger tapping and foot movement, whereas the language paradigm consisted of a two word semantic test. Statistical analysis of the data was done using the Kolmogorow-Smirnow test. Plots of signal intensities over time were created.


RESULTS
The precentral gyrus was identified in 38 of 41 patients. In two patients, fMRI was not of acceptable quality due to motion artifacts. Speech areas were localized in 33 patients. In a typical clinical setting, the value of the method was graded "high."


CONCLUSIONS
fMRI's efficacy in the preoperative localization of language and motor areas is high. The method should become a routine adjunct for preoperative evaluation of brain tumors in the near future.
Tomczak
R J
RJ
Department of Radiology, University of Ulm, Germany. reinhard.tomczak@t-online.de
Wunderlich
A P
AP
Wang
Y
Y
Braun
V
V
Antoniadis
G
G
Görich
J
J
Richter
H P
HP
Brambs
H J
HJ
D000328:Adult; D000368:Aged; D016477:Artifacts; D001254:Astrocytoma / Q000601:surgery; D001931:Brain Mapping; D001932:Brain Neoplasms / Q000503:physiopathology / Q000601:surgery*; D004292:Dominance, Cerebral / Q000502:physiology; D017352:Echo-Planar Imaging; D004558:Electric Stimulation; D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D005260:Female; D005909:Glioblastoma / Q000601:surgery; D006801:Humans; D007802:Language; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009044:Motor Cortex / Q000503:physiopathology*; D009048:Motor Skills / Q000502:physiology; D009837:Oligodendroglioma / Q000601:surgery; D010347:Patient Care Planning; D011300:Preoperative Care; D013060:Speech / Q000502:physiology; D018709:Statistics, Nonparametric