[Stereotactic resection of small intracerebral lesions in motor cortex using blood oxygen level depended functional magnetic resonance imaging and diffusion tensor imaging fusion guidance].
OBJECTIVE
To explore the effect of stereotactic resection of small intracerebral lesions located in the motor cortex using blood oxygen level depended functional magnetic resonance imaging (BOLD-fMRI) and diffusion tensor imaging (DTI) fusion guidance.


METHODS
Fifteen patients with lesions in posterior frontal lobe to anterior central gyrus, 1.5-3 cm in diameter, underwent combined three-dimensional (3D) enhancement MRI with BOLD-fMRI, and DTI. Computer procedure was used to perform the images fusion to show directly the lesions, motor cortex, and corticospinal tract, and to confirm their position relationship and design the operative approach so as to guide the stereotactic resection of the small intracerebral lesions.


RESULTS
The images fusion demonstrated that the motor cortex and corticospinal tract were located in the lateral-posterior side of the lesions, and were both compressed, reformatted and displaced. Total removal of the lesions under microscope was achieved in 12 cases, and subtotal removal in 3 cases. Histological examination showed 3 cases of meningeoma, 3 cases of astrocytoma of grade II, 2 cases of astrocytoma of grade III, 2 cases of abscess, and 2 cases of cavernous angioma. No complication was found postoperatively.


CONCLUSIONS
Mutual complementarity can be achieved by combining 3D-enhancement MRI, BOLD-fMRI, and DTI. Stereotactic resection of the small intracerebral lesions is safe, accurate and effective under the images fusion guidance.
Yang
Wei-dong
WD
Department of Neurosurgery, General Hospital of Tianjin Medical University, Tianjin 300052, China.
Wang
Zeng-guang
ZG
Zhang
Quan
Q
Pu
Pei-yu
PY
Yu
Qing
Q
Yang
Shu-yuan
SY
Zhang
Jian-ning
JN
Yue
Shu-yuan
SY
Sun
Jian
J
D000293:Adolescent; D000328:Adult; D001927:Brain Diseases / Q000473:pathology / Q000601:surgery*; D002540:Cerebral Cortex / Q000473:pathology / Q000601:surgery*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010092:Oximetry; D013238:Stereotaxic Techniques