CAJ | 학술논문

目的以术中皮层电刺激为对照,评价运动区附近脑肿瘤患者术前运用基于血氧水平依赖(BOLD)的静息态功能磁共振成像(rs-fMRI)方法定位皮质运动区的准确性.方法选取18例运动区脑肿瘤患者,手术前采用rs-fMRI定位皮质运动区,以术中皮层电刺激作为皮质运动区定位的标准技术,比较两种技术的符合度,以评价rs-fMRI定位皮质运动区的准确性.结果 rs-fMRI与术中皮层电刺激的吻合率为92.9％,肿瘤全切率为77.8％,11例术后肌力不变,4例术后肌力好转,3例术后肌力下降.结论 rs-fMRI具有较高的敏感性和精确度,可作为术前皮质运动区定位的新方法,为手术方案的制定及预后评估提供有价值的信息.
목적 이술중피층전자격위대조,평개운동구부근뇌종류환자술전운용기우혈양수평의뢰(BOLD)적정식태공능자공진성상(rs-fMRI)방법정위피질운동구적준학성.방법 선취18례운동구뇌종류환자,수술전채용rs-fMRI정위피질운동구,이술중피층전자격작위피질운동구정위적표준기술,비교량충기술적부합도,이평개rs-fMRI정위피질운동구적준학성.결과 rs-fMRI여술중피층전자격적문합솔위92.9％,종류전절솔위77.8％,11례술후기력불변,4례술후기력호전,3례술후기력하강.결론 rs-fMRI구유교고적민감성화정학도,가작위술전피질운동구정위적신방법,위수술방안적제정급예후평고제공유개치적신식.
Objective To study the relationship between the preoperative resting-state functional magnetic resonance imaging ( fMRI ) based on blood oxygen level dependent (BOLD) technique and electric cortical stimulationfor cortical mapping of primary motor cortex in patients with tumors near the central area.To research whether non-invasive preoperative resting-state fMRI can provide information equivalent to those achieved with the invasive neurosurgical " gold standard".Methods A prospective study of 18 patients with various pathological tumors of the central area was conducted.Preoperative resting-state fMRI Resting functional connectivity fMRI was documented in sequence,and compared to standardized direct electric cortical stimulation.The compound muscle action potentials of forearm flexor and hand muscle responses were recorded during DCES.Results The intraoperative direct electric cortical stimulationshowed good correlation with resting-state fMRI activation in 92.9％ of cases.Conclusions Resting-state fMRI is a high sensitive and reliable technique to locate the position of the motor areas and their spatial relation with adjacent tumor,especially for the presurgical planning in patients with central area brain tumor.