Presurgical Functional Magnetic Resonance Imaging for Resection of the Cerebral Tumors Involving Functional Areas / 中国微创外科杂志

ABSTRACT

Objective To investigate the value of presurgical functional magnetic resonance imaging(fMRI) in identifying the eloquent brain areas and guiding the resection of cerebral tumors located in these areas.Methods A total of 10 patients(aged 51.3 years on average) with tumors near to the brain functional areas were enrolled in this study,among which 7 had weakness in the limbs,2 had convulsion,and 1 suffered from facial palsy.The preoperative Karnofsky scale of the patients was 82 on average.Before the fMRI,the patients have been confirmed as having tumors involving functional areas.They were treated by total or subtotal resection according to the anatomical relationship between activated areas and the tumor.Injuries to the activated areas should be avoided during the operation.After the treatment,the muscular strength,Karnofsky scales of the patients were tested.Postoperative MRI was carried out in all of the patients,and the results were compared with that before the operation.Results As shown by fMRI,the activated areas were compressed and dislocated by the tumor in 8 of the 10 patients.The minimal distance between the edge of the tumor and the activated spots was 0-26 mm(mean,13.6).Seven of the patients received total resection of the tumor,while the other 3 underwent subtotal resection.After the surgery,the muscular strength was improved in 7 cases;the convulsion disappeared in the 2 patients who had symptom before the treatment;and the one who had facial palsy was improved.One month after the surgery,the mean Karnofsky scale of the patients was 93.Re-examination by MRI performed one week after the operation showed that the tumor was disappeared in 7 patients,and reduced by 95% to 99% in the other three.Conclusions fMRI is valuable in the preoperative evaluation of the brain functional area near to a cerebral tumor.It can be used to guide the tumor resection while preserving the motor areas.