脑内转移瘤切除术后手指运动M_1功能区重组的功能磁共振研究

Functional MRI study of reorganizat ion of M_1 area for hand movement after intracranial metastasis rese ction

目的探讨功能磁共振(bloodoxygenationleveldependentfunc-tionalMRI,BOLDfMRI)在临床医学方面的应用价值。方法对1例右侧顶叶单发转移瘤患者在手术前、后分别进行了双侧动手试验的脑功能成像。结果脑功能成像准确地反映了运动功能激活区的位置及激活程度,肿瘤侧运动区可因肿瘤占位效应产生移位,手术前的手动试验潜在功能区并未被激活,但是在肿瘤切除术后,主运动区M1以外可见潜在重组的功能区激活。结论脑内重要功能区肿瘤切除术患者,应常规进行术前和术后fMRI的研究,这对于提高术后患者生活质量、避免医源性损伤或将其减至最低水平有极大的帮助。

Aim To discuss the utility of blood oxygenation level de-pendent functional MRI (BOLD fMRI )for the motor system in patients with intracranial tumors.Methods Both hands movement activated fMRI s cans were performed in one patient with single metastasis in right parietal lo be before and after tumor resection.Results The activation in the hemisphere ipsilateral to the metastasis was pushed forwards and down by the mass ef-fect,the potential reorganization of main movement area M 1 can be activated after the tumor resection,whereas i t can' t be found before surgery.Con-clusion A pre-and post-operative fMRI study is a highly sensitive planing tool for identification of which cortical areas essential for correspon ding functions,and that this imaging mod ality plays a future role in presurgical planing to improve survive qualitie s and avoiding therapeutic damages,and it should be an ordinary examine for t he patients with intracranial tumor before interventional therapy.