title: [The application of functional magnetic resonance imaging integrated neuronavigation in localization and lingual function protection].
abstract: OBJECTIVE
  To evaluate the clinical practicability of integration of functional magnetic resonance imaging (fMRI) data into neuronavigation as a tool to localize the language area and their relationship with the lesion for the preoperative planning, intraoperative guidance and postoperative follow-up study of brain functions during minimally invasive surgeries in or adjacent to functional areas.
  
  
  METHODS
  Eighty eight patients with intracranial lesions located in or adjacent to the functional language area underwent fMRI (including examinations of lingual and visual function, and motor functions of the limbs and tongue). fMRI data was entered into a neuronavigation system for image fusion and preoperative registration and correction; minimally invasive neurosurgery was performed with fMRI navigation.
  
  
  RESULTS
  The shortest distance between the lesion and the functional cortex was less than 5 mm in 6 patients and was more than 5 mm but less than 10 mm in another 10 patients, respectively. 10 patients were recovered and improved in another 6 between 3 - 6 months after surgery, The follow-up time was between 3 months and 1 year. The morbidity rate was 6.8% (6/88). There was no postoperative mortality. Various brain areas were widely activated when the patients were reading and understanding the Chinese words. The unilateral speech functional maps were located in left Brodmann's 9, 46, 17, 18 and 19 areas.
  
  
  CONCLUSIONS
  fMRI-integrated neuronavigation can locate functional language areas and played an important role in intraoperative protection of functional lingual areas, execution of individualized therapeutic regimens, minimization of surgical complications and determination of prognosis. Total surgical resection was safe for lesions > 10 mm from functional lingual areas.
authors.affiliation: Department of Neurosurgery, Capital Medical University, Beijing, China.
authors.forename: Ming-qi
authors.initials: MQ
authors.lastname: Yang
authors.forename: Shuo
authors.initials: S
authors.lastname: Wang
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.forename: Rong
authors.initials: R
authors.lastname: Wang
authors.forename: Yuan-li
authors.initials: YL
authors.lastname: Zhao
authors.forename: Dong
authors.initials: D
authors.lastname: Zhang
authors.forename: Long
authors.initials: L
authors.lastname: Xu
authors.forename: Ji-zong
authors.initials: JZ
authors.lastname: Zhao
authors.forename: Bo
authors.initials: B
authors.lastname: Wang
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhuo
authors.forename: Lin
authors.initials: L
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001921:Brain / Q000601:surgery; D001932:Brain Neoplasms / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D038361:Neuronavigation / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods*; D014705:Verbal Behavior; D055815:Young Adult