fMRI辅助脑功能区病变手术设计的应用

Application of functional magnetic resonance imaging (fMRI) in surgical planning of cerebral motor area lesions

目的探讨功能性磁共振成像(fMRI)在脑运动区病变手术设计中的应用。方法对20例累及运动区的脑内占位病变病人术前行手握拳运动block激发模式fMRI,分析病变与运动区的关系及功能重塑情况,据此在手术中尽可能切除肿瘤并保留运动皮质的完整。结果肿瘤全切除6例,次全切除12例,部分切除2例。术前10例上肢肌力下降病人术后上肢肌力好转7例,余3例及术前肌力正常10例术后保持术前水平。结论fMRI用于运动区病变病人运动功能的客观评估和手术计划,对于降低手术带来功能缺陷的发生率具有重要意义。

Objective To explore the application of functional magnetic resonance imaging (fMRI) in surgical planning of cerebral motor area lesions. Method Twenty patients with cerebral space-occupying lesion involving motor cortex underwent fMRI with hand clenching block active mode before surgery for analyzing the relationship between the lesion and motor area, and the possibility of functional reorganization. And on the basis, the tumor is resected as completely as possible, with rendering the motor cortex intact. Result The tumor was totally resected in 6 cases, subtotally in 12 and partially resected in 2. The muscle strength of 7 out of 10 cases with decreased muscle power of upper limb improved after the operation and the other 3 cases kept pre-operative level. The muscle strength of other 10 cases with pre-operative normal muscle strength remain unchanged. Conclusion It is feasible and significant to apply fMRI in objective evaluation and pre-surgical planning of patients with motor area lesion and reduce surgical complications.