Integration of Functional Magnetic Resonance Imaging Supported by Magnetoencephalography in Functional Neuronavigation

Integration of Functional Magnetic Resonance Imaging Supported by Magnetoencephalography in... AbstractOBJECTIVEIn this study, the intraoperative visualization of functional data provided by functional magnetic resonance imaging (fMRI) and magnetoencephalography (MEG) leading to functional neuronavigation is demonstrated in surgery around the motor strip.METHODSIn seven patients with lesions adjacent to the central region, fMRI was performed with a 1.5-Tesla magnetic resonance system, using axial echo-planar imaging with a motor and a sensory task. Somatosensory and motor evoked fields were recorded with a biomagnetometer. fMRI and MEG were matched to an anatomic three-dimensional magnetic resonance image set by a contour fit. Then this three-dimensional image data set was transferred to the navigation microscope and displayed in the eyepieces of the microscope during surgery. Additionally, intraoperative recording of somatosensory evoked potentials was performed for verification of the central sulcus.RESULTSIn all cases, the projection of fMRI and MEG data into the operating viewing field allowed easy identification of the central region, which was confirmed by phase reversal of somatosensory evoked potentials in each case. fMRI and MEG measurements yielded corresponding results in each patient.CONCLUSIONFunctional neuronavigation with integration of fMRI and MEG allows the fast identification of eloquent brain areas. The widespread availability of fMRI will result in a broad availability of functional neuronavigation, which will, in turn, contribute to the successful surgery of lesions in eloquent brain areas with lower morbidity. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Integration of Functional Magnetic Resonance Imaging Supported by Magnetoencephalography in Functional Neuronavigation

Integration of Functional Magnetic Resonance Imaging Supported by Magnetoencephalography in Functional Neuronavigation

TECHNIQUE APPLICATIONS Integration of Functional Magnetic Resonance Imaging Supported by Magnetoencephalography in Functional Neuronavigation Christopher Nimsky, M .D., Oliver Ganslandt, M .D ., Helmut Kober, Ph.D., Martin Moller, M .D ., Stephan Ulmer, M .D ., Bernd Tomandl, M .D., Rudolf Fahlbusch, M.D. Department of Neurosurgery (CN, O G , H K, MM, SU , RF) and D ivision of Neuroradiology (BT), University Erlangen-Nurnberg, Erlangen, Germ any OBJECTIVE: In th is s t u d y , t h e i n t r a o p e r a t i v e v i s u a l i z a t i o n o f f u n c t i o n a l d a t a p r o v i d e d by f u n c t i o n a l m a g n e t i c resonance im a g in g ( f M R I ) a n d m a g n e t o e n c e p h a l o g r a p h y ( M E G ) le a d in g to f u n c t i o n a l n e u r o n a v i g a t i o n is d e m ­ onstrated in s u r g e r y a r o u n d t h e m o t o r s t r ip . M ETHODS: In s e v e n p a t i e n t s w i t h l e s i o n s a d j a c e n t to th e c e n t r a l r e g io n , f M R I w a s p e r f o r m e d w i t h a 1 . 5 - T e s l a magnetic r e s o n a n c e s y s t e m , u s in g a x i a l e c h o - p l a n a r im a g in g w i t h a m o t o r a n d a s e n s o r y ta sk . S o m a t o s e n s o r y a n d motor e v o k e d f ie ld s w e r e r e c o r d e d w i t h a b i o m a g n e t o m e t e r . f M R I a n d M E G w e r e m a t c h e d to a n a n a t o m i c th re e -d im e n sio n a l m a g n e t i c r e s o n a n c e im a g e set by a c o n t o u r fit. T h e n th is t h r e e - d i m e n s i o n a l im a g e d a t a se t w a s transferred to th e n a v i g a t i o n m i c r o s c o p e a n d d i s p l a y e d in th e e y e p i e c e s o f t h e m i c r o s c o p e d u r i n g s u r g e r y . Additionally, i n t r a o p e r a t i v e r e c o r d i n g o f s o m a t o s e n s o r y e v o k e d p o t e n t ia ls w a s p e r f o r m e d fo r v e r i f i c a t i o n o f th e central s u lc u s . RESULTS: In all c a s e s , t h e p r o j e c t i o n o f f M R I a n d M E...
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Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199906000-00044
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVEIn this study, the intraoperative visualization of functional data provided by functional magnetic resonance imaging (fMRI) and magnetoencephalography (MEG) leading to functional neuronavigation is demonstrated in surgery around the motor strip.METHODSIn seven patients with lesions adjacent to the central region, fMRI was performed with a 1.5-Tesla magnetic resonance system, using axial echo-planar imaging with a motor and a sensory task. Somatosensory and motor evoked fields were recorded with a biomagnetometer. fMRI and MEG were matched to an anatomic three-dimensional magnetic resonance image set by a contour fit. Then this three-dimensional image data set was transferred to the navigation microscope and displayed in the eyepieces of the microscope during surgery. Additionally, intraoperative recording of somatosensory evoked potentials was performed for verification of the central sulcus.RESULTSIn all cases, the projection of fMRI and MEG data into the operating viewing field allowed easy identification of the central region, which was confirmed by phase reversal of somatosensory evoked potentials in each case. fMRI and MEG measurements yielded corresponding results in each patient.CONCLUSIONFunctional neuronavigation with integration of fMRI and MEG allows the fast identification of eloquent brain areas. The widespread availability of fMRI will result in a broad availability of functional neuronavigation, which will, in turn, contribute to the successful surgery of lesions in eloquent brain areas with lower morbidity.

Journal

NeurosurgeryOxford University Press

Published: Jun 1, 1999

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