Identification of the pyramidal tract by neuronavigation based on intraoperative magnetic resonance tractography: Correlation with subcortical stimulation

Alessandro Bozzao, Andrea Romano, Albina Angelini, Giancarlo D'Andrea, Luigi Fausto Calabria, Valeria Coppola, Luciano Mastronardi, Luigi Maria Fantozzi, Luigi Ferrante

Research output: Contribution to journalArticle

Abstract

Objective:: To demonstrate the accuracy of magnetic resonance tractograpghy (MRT) in localizing the cortical spinal tract (CST) close to brain tumours by using intraoperative electric subcortical stimulation. Methods:: Nine patients with intra-axial brain tumours underwent neurosurgery. Planning was based on analysis of the course of streamlines compatible with the CST. After tumour removal, intraoperative MRT was reacquired. Sites at various distance from the CST were repeatedly stimulated to assess whether registered motor evoked potential (MEP) could be elicited. All patients were assessed clinically both pre- and postoperatively. Results:: The motor function was preserved in all patients. In all patients intraoperative MRT demonstrated shift of the bundle position caused by the surgical procedure. The distance between the estimated intraoperative CST and the point of elicited MEP was 1 cm or less in all nine patients. At distances greater than 2 cm, no patient reported positive MEP. Conclusion:: Intraoperative MRT is a reliable technique for localization of CST. In all patients MEP were elicited by direct subcortical electrical stimulation at a distance below 1 cm from the CST as represented by MRT. Brain shifting might impact this evaluation since CST position may change during surgery in the range of 8 mm.

Original languageEnglish
Pages (from-to)2475-2481
Number of pages7
JournalEuropean Radiology
Volume20
Issue number10
DOIs
Publication statusPublished - Oct 2010

Keywords

  • Brain tumour
  • Fibre tracking
  • Magnetic resonance imaging
  • Motor evoked potential
  • MR tractography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Bozzao, A., Romano, A., Angelini, A., D'Andrea, G., Calabria, L. F., Coppola, V., Mastronardi, L., Fantozzi, L. M., & Ferrante, L. (2010). Identification of the pyramidal tract by neuronavigation based on intraoperative magnetic resonance tractography: Correlation with subcortical stimulation. European Radiology, 20(10), 2475-2481. https://doi.org/10.1007/s00330-010-1806-7