Preoperative blood oxygen level-dependent functional magnetic resonance imaging in patients with gliomas involving the motor cortical areas.
BACKGROUND
Blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI) plays an important role in identifying functional cortical areas of the brain, especially in patients with gliomas. This study aimed to assess the value of fMRI in presurgical planning and functional outcome of patients with gliomas in the motor cortical areas.


METHODS
Twenty-six patients with gliomas in the motor cortex were recruited in the study. Before operation, fMRI was performed in each patient to obtain the mapping of bilateral hands area on the primary sensorimotor cortex. This examination was performed on a 3.0T scanner with a bilateral hands movement paradigm. During microsurgery under awake anesthesia, the motor area was identified using direct electrical stimulation and compared with preoperative mapping. Finally the tumor was resected as much as possible with the motor cortex preserved in each patient. Karnofsky performance status (KPS) was evaluated in all patients before and after operation.


RESULTS
Twenty-three patients showed a successful fMRI mapping. Among them, 19 were classified to be grade III; 4, grade II; 3, grade I. The operation time was about 7 hours in the 23 patients, 8.5 hours in the other 3. The pre- and postoperative KPS score was 82.3 +/- 8.6 and 94.2 +/- 8.1, respectively.


CONCLUSIONS
Preoperative fMRI of the hand motor area shows a high consistency with intraoperative cortical electronic stimulation. Combined use of the two methods shows a maximum benefit in surgical treatment.
Xie
Jian
J
Department of Neurosurgery, Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing 100050, China.
Chen
Xu-zhu
XZ
Jiang
Tao
T
Li
Shou-wei
SW
Li
Zi-xiao
ZX
Zhang
Zhong
Z
Dai
Jian-ping
JP
Wang
Zhong-cheng
ZC
D000328:Adult; D001932:Brain Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D005910:Glioma / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000473:pathology*; D010100:Oxygen / Q000097:blood*
D010100:Oxygen