title: Identifying the central sulcus in patients with intra-axial lesions: a multicenter study comparing conventional presurgical MRI to topographical analysis and BOLD-fMRI.
abstract: OBJECTIVE
  Identification of eloquent brain areas in patients with intra-axial lesions is important to minimize the risk of neurological deficit. We performed a multicenter study comparing conventional 2-dimensional magnetic resonance imaging (MRI) for identification of the central sulcus to topographical MRI and blood-oxygenation-level-dependent functional MRI (BOLD-fMRI).
  
  
  METHODS
  Seventy-seven unoperated patients with brain lesions were imaged at 1.5 or 3 T. The central sulcus was identified by an experienced neuroradiologist on 2-dimensional MRI, by topographic analysis of 3-dimensional MRI in BrainVoyager, and by BOLD-fMRI analysis in BrainVoyager or SPM5.
  
  
  RESULTS
  The central sulcus in the affected hemisphere was readily identified in a significantly higher percentage of patients by 2-dimensional MRI and topographical analysis (77/77 patients) compared to BOLD-fMRI (57 patients; P < 0.001). The topographical analysis identified a significantly larger portion of the total central sulcus than 2-dimensional MRI (P < 0.05). No differences were found between institutions, histological versus radiological diagnoses, MRI sequence parameters, age, or sex.
  
  
  CONCLUSIONS
  Identification of the central sulcus is best performed using topographical analysis; however, 2-dimensional analysis may suffice for daily routine work.
authors.affiliation: From the *Department of Radiology, and †Intervention Centre, Clinic for Imaging and Intervention, Oslo University Hospital, Rikshospitalet; ‡Institute of Psychology, University of Oslo, Oslo; §Department of Radiology, Clinic of Radiology and Nuclear Medicine, St Olavs Hospital, Trondheim University Hospital, Trondheim; and ∥Institute of Physics, University of Oslo, Oslo, Norway.
authors.forename: Paulina
authors.initials: P
authors.lastname: Due-Tonnessen
authors.forename: Inge
authors.initials: I
authors.lastname: Rasmussen
authors.forename: Erik Magnus
authors.initials: EM
authors.lastname: Berntsen
authors.forename: Atle
authors.initials: A
authors.lastname: Bjornerud
authors.forename: Kyrre E
authors.initials: KE
authors.lastname: Emblem
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000473:pathology*; D002648:Child; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D002538:Intracranial Arteriovenous Malformations / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000473:pathology*; D012189:Retrospective Studies