功能磁共振成像对顽固性癫痫手术前的功能区定位的初步研究

Pre-operative brain functional mapping using fMRI in patients with intractable epilepsy

目的 利用功能磁共振成像技术显示顽固性癫痫患者脑内致痫灶周围重要功能脑区的位置 ,避免手术损伤及术后功能障碍。方法 对 4例顽固性癫痫患者于手术前分别进行了运动、语言及视觉的磁共振脑功能成像扫描。结果 4例患者经不同刺激任务的功能成像扫描及数据处理后 ,均成功地显示了各自相应的运动、语言、视觉功能活动区的范围及程度 ,为致痫灶与其周围不同脑功能区的关系提供了直观、准确的信息。结论 功能磁共振成像的临床应用是一项极具前景的工作 ,它对神经外科完整切除脑内病灶 ,同时减少因手术而导致的脑功能障碍提供了极大的帮助。

Objective To find out the important functional brain areas around the epilepsy focus in pre-operative patients with intractable epilepsy,and thus improving the surgical plan and avoiding possible damage.Methods Bold fMRI experiments using single-shot GE-EPI were performed on 4 pre-surgical patients aging from 14 to 23 years,the block designed tasks were devised for different functions of precise hand movement,language and visualization.Results The 4 intractable epilepsy patients co-operated well during the fMRI scans. Spatial relations between epilepsy focus and corresponding functional activations of motor,language and visualization were clearly demonstrated.Conclusion Non-invasive fMRI combination with clinical purpose is a more inspiring work,it is a highly sensitive preoperative tool for the identification of which cortical are essential for motor,language and vision,and it can help the neurosurgeons to resect the epilepsy focus perfectly and to avoid the complication of neurological dysfunction from iatrogenic damage,and that this imaging modality may play a future role in presurgical planning for patients with intracranial disease.