title: The use of functional magnetic resonance imaging in reducing a risk of postoperative neurological deficits in the patients with brain tumour.
abstract: OBJECTIVE
  The purpose of the study was to compare the results of operative treatment of tumours located in the sensory-motor cortex guided with functional magnetic resonance imaging (fMRI) combined with the neuro-na-vigation system to the results of classical operative treatment.
  
  
  METHODS
  The studied group comprised 28 pa-tients with a tumour located in the sensory-motor cortex area who underwent surgery guided with fMRI and the neuro-na-vigation system. A control group comprised 30 patients with the same clinical diagnosis, operated on without functional neuronavigation.
  
  
  RESULTS
  The use of functional neuronavigation allowed for an 18% reduction in the intensity of neurological deficits after surgical treatment in patients from the studied group, compared to the subjects from the control group (p = 0.0001). In the patients with diagnosed high-grade glioma, improvement in the neurological condition in the studied group was 16% (p = 0.03). The initial neurological condition and the results of surgical treatment in patients with a tumour located less than 5 mm from the sensory-motor cortex, determined in fMRI examination, are worse than in patients with a tumour located more than 5 mm.
  
  
  CONCLUSIONS
  In patients with a diagnosed brain tumour in the sensory-motor cortex who have neurological deficits, fMRI provides valuable imaging data on active areas. Tumour location of more than 5 mm from the fMRI active area of the sensory-motor cortex is connected with a considerably lower risk of postoperative neurological deficits. Removing a tumour in the sensory-motor cortex region, guided with fMRI and the neuronavigation system, considerably lowers the risk of postoperative development or exacerbation of neurological deficits.
authors.affiliation: dr med. Michał Tymowski, Katedra i Oddział Kliniczny Neurochirurgii, Plac Medyków 1, 41-200 Sosnowiec, Polska, e-mail: tymowski.michal@gmail.com.
authors.forename: Michał
authors.initials: M
authors.lastname: Tymowski
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Majchrzak
authors.forename: Barbara
authors.initials: B
authors.lastname: Bobek-Billewicz
authors.forename: Piotr
authors.initials: P
authors.lastname: Ladziński
authors.forename: Henryk
authors.initials: H
authors.lastname: Majchrzak
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000473:pathology* / Q000601:surgery*; D009460:Neurologic Examination; D038361:Neuronavigation / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control*; D011184:Postoperative Period; D025321:Surgery, Computer-Assisted / Q000379:methods; D055815:Young Adult