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目的以术中电刺激运动诱发电位(MEP)监测为对照,评价中央区脑肿瘤术前运用血液氧饱和水平检测(BOLD)技术的功能磁共振成像(fMR I)定位皮质运动区的准确性。方法此项前瞻性研究选取了16例中央区脑肿瘤。开颅手术前分别执行手运动激发程式,运用BOLD技术的fMR I定位皮质运动区。将fMR I影像与磁共振导航序列影像融合。以术中MEP监测作为皮质运动区定位的标准技术。在神经导航下定位fMR I的各个激活区,单独或联合运用短串经颅电刺激(TCES)和直接皮质电刺激(DCES),在前臂及手部记录复合肌肉动作电位。比较两种技术的吻合度,以评价fMR I定位的皮质运动区的准确性。结果fMR I与MEP的吻合率为92.3%,其中与TCES的吻合率为100.0%,与DCES的吻合率为66.7%。结论运用BOLD技术的fMR I敏感度高,可实现中央区脑肿瘤术前皮质运动区的准确定位。
Objective To evaluate the accuracy of magnetic resonance imaging (fMRI) of the blood oxygen saturation level (BOLD) technique in the central region of brain tumors before operation to evaluate the effect of intraoperative electromyographic exercise-induced potential (MEP) monitoring. Methods This prospective study selected 16 patients with central brain tumors. Manual craniotomy was performed before craniotomy, and fMRI with BOLD technique was used to locate cortical areas. Fusion of fMR I images with magnetic resonance navigation sequence images. Intraoperative MEP monitoring as a cortical motor area positioning standard technology. Under the guidance of neuro-navigation, all the active regions of fMRI were located, and the combined action potentials were recorded on the forearm and hands either singly or in combination with TCES and DCES. The agreement between the two techniques was compared to assess the accuracy of the fMRI-targeted cortical motor zone. Results The coincidence rate of fMR I and MEP was 92.3%. The coincidence rate with TCES was 100.0% and the coincidence rate with DCES was 66.7%. Conclusions The fMRI sensitivity of BOLD technique can be used to accurately locate preoperative cortical motor regions in brain tumors of central region.