Purpose

Functional magnetic resonance imaging (fMRI) has an established role in neurosurgical planning; however, ambiguity surrounds the comparative value of resting and task-based fMRI relative to anatomical localization of the sensorimotor cortex. This study was carried out to determine: 1) how often fMRI adds to prediction of motor risks beyond expert neuroradiological review, 2) success rates of presurgical resting and task-based sensorimotor mapping, and 3) the impact of accelerated resting fMRI acquisitions on network detectability.

Methods

Data were collected at 2 centers from 71 patients with a primary brain tumor (31 women; mean age 41.9 ± 13.9 years) and 14 healthy individuals (6 women; mean age 37.9 ± 12.7 years). Preoperative 3T MRI included anatomical scans and resting fMRI using unaccelerated (TR = 3.5 s), intermediate (TR = 1.56 s) or high temporal resolution (TR = 0.72 s) sequences. Task fMRI finger tapping data were acquired in 45 patients. Group differences in fMRI reproducibility, spatial overlap and success frequencies were assessed with t‑tests and χ²-tests.

Results

Radiological review identified the central sulcus in 98.6% (70/71) patients. Task-fMRI succeeded in 100% (45/45). Resting fMRI failed to identify a sensorimotor network in up to 10 patients; it succeeded in 97.9% (47/48) of accelerated fMRIs, compared to only 60.9% (14/23) of unaccelerated fMRIs (\(\chi\)(2) = 17.84, p < 0.001). Of the patients 12 experienced postoperative deterioration, largely predicted by anatomical proximity to the central sulcus.

Conclusion

The use of fMRI in patients with residual or intact presurgical motor function added value to uncertain anatomical localization in just a single peri-Rolandic glioma case. Resting fMRI showed high correspondence to task localization when acquired with accelerated sequences but offered limited success at standard acquisitions.

中文翻译：

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胶质瘤初级感觉运动皮层的术前定位

目的

功能性磁共振成像 (fMRI) 在神经外科计划中具有确定的作用；然而，与感觉运动皮层解剖定位相关的静息和基于任务的 fMRI 的比较价值存在歧义。进行这项研究是为了确定：1）fMRI 在专家神经放射学审查之外增加运动风险预测的频率，2）术前静息和基于任务的感觉运动映射的成功率，以及 3）加速静息 fMRI 采集对网络的影响可探测性。

方法

在 2 个中心收集了 71 名原发性脑肿瘤患者（31 名女性；平均年龄 41.9 ± 13.9 岁）和 14 名健康个体（6 名女性；平均年龄 37.9 ± 12.7 岁）的数据。术前 3T MRI 包括使用非加速 (TR = 3.5 s)、中间 (TR = 1.56 s) 或高时间分辨率 (TR = 0.72 s) 序列的解剖扫描和静息 fMRI。45 名患者获得了任务 fMRI 手指敲击数据。在fMRI的再现性组间差异，空间重叠和成功的频率用t检验评估和χ ^2个-tests。

结果

放射学检查确定了 98.6% (70/71) 患者的中央沟。Task-fMRI 成功率为 100% (45/45)。静息功能磁共振成像未能识别多达 10 名患者的感觉运动网络；它在 97.9% (47/48) 的加速 fMRI 中成功，而未加速 fMRI 只有 60.9% (14/23) ( \(\chi\) (2) = 17.84, p  < 0.001)。在 12 名患者中，有 12 名出现术后恶化，这主要是根据解剖学上与中央沟的接近程度来预测的。

结论

仅在单个 Rolandic 神经胶质瘤病例中，在具有残余或完整术前运动功能的患者中使用 fMRI 为不确定的解剖定位增加了价值。当使用加速序列采集时，静息 fMRI 显示出与任务定位的高度对应，但在标准采集中取得的成功有限。