RISONANZA MAGNETICA FUNZIONALE: LOCALIZZAZIONE DELL'AREA MOTORIA PRIMARIA IN PAZIENTI PORTATORI DI LESIONI ESPANSIVE CEREBRALI. RISULTATI PRELIMINARI

Translated title of the contribution: Functional magnetic resonance: Primary motor cortex localization in patients with brain neoplasms. Preliminary results

A. Righini, O. De Divitiis, A. Prinster, D. Spagnoli, I. Apollonio, I. Bello, G. Tomei, R. Villani, F. Fazio, M. Leonardi

Research output: Contribution to journalArticlepeer-review

Abstract

Neoplasms compressing or infiltrating cerebral cortex often alter the normal anatomy in such a way that the neurosurgeon can not easily localize and spare functional areas. Moreover, the results of mass effect on brain functional anatomy have not been extensively investigated in vivo yet. The aims of the present study were the following: a) to test FMRI capability to localize with a conventional scanner the primary motor cortex of the hand in patients with brain neoplasms; b) to compare activated areas in the pathologic hemisphere with the correspondent contralateral ones. Fifteen right handed patients with frontal-parietal intra and extra axial tumors (4 glioblastomas, 4 astrocytomas, 2 mengingiomas, 3 angiomas, 2 single metastasis) were studied. Clinically, hand movement performance ranged from normal to slight impairment of fingers dexterity. The subjects were scanned using a 1.5T MR unit (Magnetom, Siemens, Germany) equipped with conventional gradients (10 mT/m). The MFRI study was based on series of spoiled FLASH images (TR/TE = 63/40 ms, flip angle = 100, matrix = 128x128, fov = 240 mm, slice thickness = 5 mm, acquisition time = 11 sec). Two or three contiguous sections (parallel to the bicommissural plane) were acquired through the level of frontal-parietal cortex. Each patient was requested to perform either a finger tapping task or an easier flexion-extension movement with the hand contralateral to the lesion. Until now, three patients, with no residual motor deficits, have also been studied two weeks, four and six months respectively after surgery. Five patients were excluded because of gross motion artifacts. In all other patients, areas of significant signal increase (3.5-8.6%) were detected either within or on the edge of the precentral gyrus. In some cases the activated areas were well separated from the neoplasm, in some others they were visible on the border between tumoral and normal tissue, however no activated pixels were detectable within the neoplasms. Some activation signal was clearly present within edematous parenchyma. When mass effect was remarkable, the activated area in the affected hemisphere was displaced with respect to the contralateral one. In two of the three cases studied after surgery, the activated area returned to a position more similar to the one in the unaffected side. Areas of significantly increased signal are still observable even in a cortex where normal anatomical patterns are lost.

Translated title of the contributionFunctional magnetic resonance: Primary motor cortex localization in patients with brain neoplasms. Preliminary results
Original languageItalian
Pages (from-to)371-381
Number of pages11
JournalRivista di Neuroradiologia
Volume8
Issue number3
Publication statusPublished - 1995

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

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