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Article: Blood oxygen level-dependent functional magnetic resonance imaging in preoperative brain mapping and making surgical decisions

TitleBlood oxygen level-dependent functional magnetic resonance imaging in preoperative brain mapping and making surgical decisions
Authors
KeywordsArteriovenous malformation
Astrocytoma
Brain cortex
Brain malformation
Brain mapping
Issue Date2011
PublisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkjr.org
Citation
Hong Kong Journal of Radiology, 2011, v. 14 n. 3, p. 147-154 How to Cite?
AbstractObjective: To evaluate the efficacy of blood oxygen level–dependent functional magnetic resonance imaging in the preoperative mapping of sensorimotor cortices and language areas, and its impact on surgical decisions. Methods: Fourteen patients with tumours or vascular malformations underwent functional magnetic resonance imaging (in the course of motor, sensory, and language tasks) and had structural magnetic resonance imaging scans in a 1.5T scanner. The functional magnetic resonance imaging findings were then correlated with their operative and clinical outcomes. Seven patients had a craniotomy with general anaesthesia, three had awake craniotomy with intraoperative mapping, two had radiosurgery, and two had no surgery. Results: The technical success rate of functional magnetic resonance imaging signal activation in identifying eloquent cortices was 100% for all tasks except Chinese reading, for which the success rate was 83%. Functional magnetic resonance imaging mapping accuracy was determined by correlation with intraoperative cortical stimulation or somatosensory-evoked potentials phase reversal. Surgical decision making was influenced by functional magnetic resonance imaging in 75% of the patients, using a more aggressive approach in two patients and a safer approach in two others (due to lesion proximity of <2 cm from eloquent centres). More conventional craniotomies were performed in five patients due to larger margins (>2 cm) or contralateral location of the language centre. In one patient, there were conflicting results between Wada test and functional magnetic resonance imaging with respect to speech lateralisation; intraoperative cortical stimulation found that functional magnetic resonance imaging correctly predicted the side of speech dominance. Conclusion: Blood oxygen level–dependent functional magnetic resonance imaging had a high technical success rate and was very accurate in mapping eloquent cortical areas preoperatively. Its role in preoperative surgical assessment is pivotal, and is recommended for most, if not all, resective brain surgery.
血氧水平依賴腦功能磁共振成像對於 術前研究腦功能區活動的效用及對手術方式的影響 麥嘉豐、張粼達、馮仕庭、楊家威、陳達明、朱献倫、潘偉生 目的:評估血氧水平依賴腦功能磁共振成像對於術前研究感應運動腦皮質區及語言區活動的效用, 以及對手術方式採用決定的影響。 方法:14名患有腫瘤或血管畸形的病人接受功能磁共振成像(通過運動、感覺及語言任務)及1.5T 的結構磁共振成像。並探討功能磁共振成像的結果與術中及臨床結果的相關性。最終共有7名病人接 受全身麻醉的顱骨切開術、3人接受喚醒麻醉的顱骨切開術及術中成像、2人接受放射外科手術、2人 未有接受手術。 結果:使用功能磁共振成像的信號強度辨認語言功能區的技術性成功率為100%,但閱讀中文方面則 只有83%。腦功能磁共振成像的準確度的驗證取决於術中皮層電刺激或皮層體感誘發電位逆轉。有 75%病人因功能磁共振成像的結果而影響其做手術方式的決定,其中2人採用更進取的方法,另2人 因病灶距離語言功能區只有不足2 cm,所以採用較安全的方法。另5人由於距離大(超過2 cm)或語 言區在對側位置,遂進行傳統的顱骨切開術。另1人的瓦達測試(Wada test)與功能磁共振成像在語 言側化方面的結果矛盾,後進行術中皮層電刺激測試確定功能磁共振成像正確預測語言區優勢的一 邊。 結論:血氧水平依賴腦功能磁共振成像有較高技術成功率,在術前辨認語言功能區方面相當準確。 此技術對於術前評估起了關鍵作用,可推薦作大部分腦腫瘤切開術用作術前評估。
Persistent Identifierhttp://hdl.handle.net/10722/150924
ISSN
2015 SCImago Journal Rankings: 0.113
References

 

DC FieldValueLanguage
dc.contributor.authorMak, HKFen_US
dc.contributor.authorZhang, Len_US
dc.contributor.authorFeng, ZTen_US
dc.contributor.authorYeung, DKWen_US
dc.contributor.authorChan, DTMen_US
dc.contributor.authorZhu, XLen_US
dc.contributor.authorPoon, WSen_US
dc.date.accessioned2012-06-26T06:14:32Z-
dc.date.available2012-06-26T06:14:32Z-
dc.date.issued2011en_US
dc.identifier.citationHong Kong Journal of Radiology, 2011, v. 14 n. 3, p. 147-154en_US
dc.identifier.issn2223-6619en_US
dc.identifier.urihttp://hdl.handle.net/10722/150924-
dc.description.abstractObjective: To evaluate the efficacy of blood oxygen level–dependent functional magnetic resonance imaging in the preoperative mapping of sensorimotor cortices and language areas, and its impact on surgical decisions. Methods: Fourteen patients with tumours or vascular malformations underwent functional magnetic resonance imaging (in the course of motor, sensory, and language tasks) and had structural magnetic resonance imaging scans in a 1.5T scanner. The functional magnetic resonance imaging findings were then correlated with their operative and clinical outcomes. Seven patients had a craniotomy with general anaesthesia, three had awake craniotomy with intraoperative mapping, two had radiosurgery, and two had no surgery. Results: The technical success rate of functional magnetic resonance imaging signal activation in identifying eloquent cortices was 100% for all tasks except Chinese reading, for which the success rate was 83%. Functional magnetic resonance imaging mapping accuracy was determined by correlation with intraoperative cortical stimulation or somatosensory-evoked potentials phase reversal. Surgical decision making was influenced by functional magnetic resonance imaging in 75% of the patients, using a more aggressive approach in two patients and a safer approach in two others (due to lesion proximity of <2 cm from eloquent centres). More conventional craniotomies were performed in five patients due to larger margins (>2 cm) or contralateral location of the language centre. In one patient, there were conflicting results between Wada test and functional magnetic resonance imaging with respect to speech lateralisation; intraoperative cortical stimulation found that functional magnetic resonance imaging correctly predicted the side of speech dominance. Conclusion: Blood oxygen level–dependent functional magnetic resonance imaging had a high technical success rate and was very accurate in mapping eloquent cortical areas preoperatively. Its role in preoperative surgical assessment is pivotal, and is recommended for most, if not all, resective brain surgery.en_US
dc.description.abstract血氧水平依賴腦功能磁共振成像對於 術前研究腦功能區活動的效用及對手術方式的影響 麥嘉豐、張粼達、馮仕庭、楊家威、陳達明、朱献倫、潘偉生 目的:評估血氧水平依賴腦功能磁共振成像對於術前研究感應運動腦皮質區及語言區活動的效用, 以及對手術方式採用決定的影響。 方法:14名患有腫瘤或血管畸形的病人接受功能磁共振成像(通過運動、感覺及語言任務)及1.5T 的結構磁共振成像。並探討功能磁共振成像的結果與術中及臨床結果的相關性。最終共有7名病人接 受全身麻醉的顱骨切開術、3人接受喚醒麻醉的顱骨切開術及術中成像、2人接受放射外科手術、2人 未有接受手術。 結果:使用功能磁共振成像的信號強度辨認語言功能區的技術性成功率為100%,但閱讀中文方面則 只有83%。腦功能磁共振成像的準確度的驗證取决於術中皮層電刺激或皮層體感誘發電位逆轉。有 75%病人因功能磁共振成像的結果而影響其做手術方式的決定,其中2人採用更進取的方法,另2人 因病灶距離語言功能區只有不足2 cm,所以採用較安全的方法。另5人由於距離大(超過2 cm)或語 言區在對側位置,遂進行傳統的顱骨切開術。另1人的瓦達測試(Wada test)與功能磁共振成像在語 言側化方面的結果矛盾,後進行術中皮層電刺激測試確定功能磁共振成像正確預測語言區優勢的一 邊。 結論:血氧水平依賴腦功能磁共振成像有較高技術成功率,在術前辨認語言功能區方面相當準確。 此技術對於術前評估起了關鍵作用,可推薦作大部分腦腫瘤切開術用作術前評估。-
dc.languageengen_US
dc.publisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkjr.orgen_US
dc.relation.ispartofHong Kong Journal of Radiologyen_US
dc.rightsHong Kong Journal of Radiology. Copyright © Hong Kong Academy of Medicine Press.-
dc.subjectArteriovenous malformationen_US
dc.subjectAstrocytomaen_US
dc.subjectBrain cortexen_US
dc.subjectBrain malformation-
dc.subjectBrain mapping-
dc.titleBlood oxygen level-dependent functional magnetic resonance imaging in preoperative brain mapping and making surgical decisionsen_US
dc.typeArticleen_US
dc.identifier.emailMak, HKF: makkf@hkucc.hku.hken_US
dc.identifier.authorityMak, HKF=rp00533en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.scopuseid_2-s2.0-82755196282en_US
dc.identifier.hkuros192693-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-82755196282&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume14en_US
dc.identifier.issue3en_US
dc.identifier.spage147en_US
dc.identifier.epage154en_US
dc.publisher.placeHong Kongen_US
dc.identifier.scopusauthoridPoon, WS=7103025507en_US
dc.identifier.scopusauthoridZhu, XL=34980206900en_US
dc.identifier.scopusauthoridChan, DTM=7402216549en_US
dc.identifier.scopusauthoridYeung, DKW=35290812300en_US
dc.identifier.scopusauthoridFeng, ST=15022257300en_US
dc.identifier.scopusauthoridZhang, L=54789362500en_US
dc.identifier.scopusauthoridMak, HKF=7004699149en_US

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