title: Preoperative assessment using multimodal functional magnetic resonance imaging techniques in patients with brain gliomas.
abstract: OBJECTIVE
  To evaluate the value of magnetic resonance spectroscopy (MRS), blood     oxygen level-dependent imaging (BOLD) and diffusion tensor imaging (DTI) for     preoperative assessment in patients with brain gliomas.
  
  
  METHODS
  Twenty-three consecutive glioma patients underwent MRS, BOLD and DTI before     operation. The characteristics of images were analysed according to     histopathological results.
  
  
  RESULTS
  There is significant elevation of the     choline (Cho) /creatine (Cr) ratio, Cho peak and depression of the     N-acetylaspartate (NAA) peak in gliomas. Elevation of the Cho/Cr, Cho/NAA ratio     and the presence of a lipids peak, were consistent with high-grade malignancy. A     motor activation scan was achieved by using a motor task paradigm in 20     patients. Deformation and displacement of the motor activations was found in 5     cases. The margin of tumor and peritumoural white matter tracts were identified     using apparent diffusion coefficient (ADC) and fractional anisotropy (FA) maps.     Three patterns of white matter tracts alteration were identified: displacement,     infiltration, and disruption. In all 23 patients, the tumors were completely     resected in 6 patients, subtotal resected in 8 patients, partial resected in 9     patients. No secondary neurological deficit was occurred in all patients after     operation.
  
  
  CONCLUSIONS
  The combination of MRS, BOLD, and DTI techniques allows     appropriate presurgical planning of brain gliomas.
authors.affiliation: Rui Jin Hospital, Shanghai Jiao Tong University, Faculty of Medicine, Department of Neurosurgery, Shanghai, China.
authors.forename: Han-bing
authors.initials: HB
authors.lastname: Shang
authors.forename: Wei-guo
authors.initials: WG
authors.lastname: Zhao
authors.forename: Wei-feng
authors.initials: WF
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016880:Anisotropy; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D002540:Cerebral Cortex / Q000473:pathology; D002648:Child; D002794:Choline / Q000378:metabolism; D003337:Corpus Callosum / Q000473:pathology; D003401:Creatine / Q000378:metabolism; D056324:Diffusion Tensor Imaging; D005260:Female; D005910:Glioma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D010100:Oxygen / Q000097:blood; D011859:Radiography; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline; D010100:Oxygen