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Assessment of functional MR imaging in neurosurgical planning.
- Source :
-
AJNR. American journal of neuroradiology [AJNR Am J Neuroradiol] 1999 Sep; Vol. 20 (8), pp. 1511-9. - Publication Year :
- 1999
-
Abstract
- Background and Purpose: Presurgical sensorimotor mapping with functional MR imaging is gaining acceptance in clinical practice; however, to our knowledge, its therapeutic efficacy has not been assessed in a sizable group of patients. Our goal was to identify how preoperative sensorimotor functional studies were used to guide the treatment of neuro-oncologic and epilepsy surgery patients.<br />Methods: We retrospectively reviewed the medical records of 46 patients who had undergone preoperative sensorimotor functional MR imaging to document how often and in what ways the imaging studies had influenced their management. Clinical management decisions were grouped into three categories: for assessing the feasibility of surgical resection, for surgical planning, and for selecting patients for invasive functional mapping procedures.<br />Results: Functional MR imaging studies successfully identified the functional central sulcus ipsilateral to the abnormality in 32 of the 46 patients, and these 32 patients are the focus of this report. In epilepsy surgery candidates, the functional MR imaging results were used to determine in part the feasibility of a proposed surgical resection in 70% of patients, to aid in surgical planning in 43%, and to select patients for invasive surgical functional mapping in 52%. In tumor patients, the functional MR imaging results were used to determine in part the feasibility of surgical resection in 55%, to aid in surgical planning in 22%, and to select patients for invasive surgical functional mapping in 78%. Overall, functional MR imaging studies were used in one or more of the three clinical decision-making categories in 89% of tumor patients and 91% of epilepsy surgery patients.<br />Conclusion: Preoperative functional MR imaging is useful to clinicians at three key stages in the preoperative clinical management paradigm of a substantial percentage of patients who are being considered for resective tumor or epilepsy surgery.
- Subjects :
- Adolescent
Adult
Brain Neoplasms diagnosis
Brain Neoplasms physiopathology
Cerebral Cortex physiopathology
Cerebral Cortex surgery
Child
Epilepsy etiology
Epilepsy physiopathology
Feasibility Studies
Female
Humans
Male
Middle Aged
Patient Care Planning
Preoperative Care
Retrospective Studies
Treatment Outcome
Brain Mapping
Brain Neoplasms surgery
Epilepsy surgery
Evoked Potentials, Motor physiology
Evoked Potentials, Somatosensory physiology
Image Processing, Computer-Assisted
Magnetic Resonance Imaging
Subjects
Details
- Language :
- English
- ISSN :
- 0195-6108
- Volume :
- 20
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- AJNR. American journal of neuroradiology
- Publication Type :
- Academic Journal
- Accession number :
- 10512239