静息态脑功能成像与皮层电刺激定位皮质运动区的对照研究  

Localizasing primary motor area with resting -state fMRI compared with electric cortical stimulation： a primary study

作　　者：吴亮[1] 王晓东[4] 贾培雷[1] 夏鹤春[2] 马辉[2] 陈学新[3] 赵建国[4] 王万弟[5] 

机构地区：[1]宁夏医科大学,银川750004 [2]宁夏医科大学总医院神经外科 [3]宁夏医科大学总医院麻醉科 [4]宁夏医科大学总医院放射科 [5]宁夏医科大学总医院神经电生理科

出　　处：《中华神经外科杂志》2012年第7期722-725,共4页Chinese Journal of Neurosurgery

基　　金：宁夏回族自治区科技攻关资助项目（2011-89）;2008年度宁夏自然科学基金项目（NZ08121）

摘　　要：目的以术中皮层电刺激为对照，评价运动区附近脑肿瘤患者术前运用基于血氧水平依赖（BOLD）的静息态功能磁共振成像（rs—fMRI）方法定位皮质运动区的准确性。方法选取18例运动区脑肿瘤患者，手术前采用rs-fMRI定位皮质运动区，以术中皮层电刺激作为皮质运动区定位的标准技术，比较两种技术的符合度，以评价rs—fMRI定位皮质运动区的准确性。结果rs—fMRI与术中皮层电刺激的吻合率为92．9％，肿瘤全切率为77．8％，11例术后肌力不变，4例术后肌力好转，3例术后肌力下降。结论rs—fMRI具有较高的敏感性和精确度，可作为术前皮质运动区定位的新方法，为手术方案的制定及预后评估提供有价值的信息。Objective To study the relationship between the preoperative resting - state functional magnetic r,~sonance imaging （fMRI） based on blood oxygen level dependent （BOLD） technique and electric cortical stimulationfor cortical mapping of primary motor cortex in patients with tumors near the central area. To research whether non - invasive preoperative resting - state fMRI can provide information equivalent to those achieved with the invasive neurosurgical ＂gold standard＂. Methods A prospective study of 18 patients with various pathological tumors of the central area was conducted. Preoperative resting - state fMRI Resting functional connectivity fMRI was documented in sequence, and compared to standardized direct electric cortical stimulation. The compound muscle action potentials of forearm flexor and hand muscle responses were recorded during DCES. Results The intraoperative direct electric cortical stimulationshowed good correlation with resting - state fMRI activation in 92. 9% of cases. Conclusions Resting - state fMRI is a high sensitive and reliable technique to locate the position of the motor areas and their spatial relation with adjacent tumor, especially for the presurgical planning in patients with central area brain tumor.

关 键 词：功能磁共振成像 静息态 运动皮质 皮层电刺激 

分 类 号：R445.2[医药卫生—影像医学与核医学]