title: Anatomic study of the central core of the cerebrum correlating 7-T magnetic resonance imaging and fiber dissection with the aid of a neuronavigation system.
abstract: BACKGROUND
  Different strategies have been used to study the fiber tract anatomy of the human brain in vivo and ex vivo. Nevertheless, the ideal method to study white matter anatomy has yet to be determined because it should integrate information obtained from multiple sources.
  
  
  OBJECTIVE
  We developed an anatomic method in cadaveric specimens to study the central core of the cerebrum combining traditional white matter dissection with high-resolution 7-T magnetic resonance imaging (MRI) of the same specimen coregistered using a neuronavigation system.
  
  
  METHODS
  Ten cerebral hemispheres were prepared using the traditional Klingler technique. Before dissection, a structural ultrahigh magnetic field 7-T MRI study was performed on each hemisphere specifically prepared with surface fiducials for neuronavigation. The dissection was then performed from the medial hemispheric surface using the classic white fiber dissection technique. During each step of the dissection, the correlation between the anatomic findings and the 7-T MRI was evaluated with the neuronavigation system.
  
  
  RESULTS
  The anatomic study was divided in 2 stages: diencephalic and limbic. The diencephalic stage included epithalamic, thalamic, hypothalamic, and subthalamic components. The limbic stage consisted of extending the dissection to complete the Papez circuit. The detailed information given by the combination of both methods allowed us to identify and validate the position of fibers that may be difficult to appreciate and dissect (ie, the medial forebrain bundle).
  
  
  CONCLUSIONS
  The correlation of high-definition 7-T MRI and the white matter dissection technique with neuronavigation significantly improves the understanding of the structural connections in complex areas of the human cerebrum.
authors.affiliation: *Laboratory of Surgical Neuroanatomy (LSNA), Universitat de Barcelona, Barcelona, Spain; ‡Department of Neurosurgery, Hospital Universitario de Bellvitge, Barcelona, Spain; §Department of Neurosurgery, Hospital Clinic, Barcelona, Spain; ¶Experimental MRI 7T Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; ‖Department of Neurosurgery, University of Pisa, Pisa, Italy; #Department of Neurosurgery, Division of Neurosurgery, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Carlos
authors.initials: C
authors.lastname: Alarcon
authors.forename: Matteo
authors.initials: M
authors.lastname: de Notaris
authors.forename: Kenneth
authors.initials: K
authors.lastname: Palma
authors.forename: Guadalupe
authors.initials: G
authors.lastname: Soria
authors.forename: Alessandro
authors.initials: A
authors.lastname: Weiss
authors.forename: Amin
authors.initials: A
authors.lastname: Kassam
authors.forename: Alberto
authors.initials: A
authors.lastname: Prats-Galino
mesh_terms: D002531:Cerebellum / Q000033:anatomy & histology*; D004210:Dissection / Q000379:methods; D006801:Humans; D008032:Limbic System / Q000033:anatomy & histology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D038361:Neuronavigation / Q000379:methods*; D013687:Telencephalon / Q000033:anatomy & histology / Q000601:surgery