Application Of Resting-state FMRI On The Treatment Of Lesions Involving The Motor Area

Objective To compare the relation between the preoperative resting-state functionalmagnetic resonance imaging(rs-fMRI) based on blood oxygen level dependent(BOLD)technique and electric cortical stimulation for cortical mapping of primary motor cortex inpatients with tumors in or around the central area.To evaluate the clinical value of fMRIfunctional connectivity in the surgical resection of brain tumor involving the motor area.Methods A prospective study of18patients with various pathological tumors of thecentral area was conducted. Preoperative resting-state fMRI scans using the BOLD contrasttechnique in each patient were performed, then establishing the functional connectivity ofmotor areas,visual display the interval relationship between tumor and motor cortex andmaking surgical plan preoperative.Using direct electric cortical stimulation to local motorareas, displaying the three-dimensional positional relationship of tumors, motor cortex and thepositive sites of electrical stimulation under awake craniotomy.Resting functionalconnectivity fMRI were documented in sequence, and compared to standardized directelectric cortical stimulation,evaluating the accuracy of fMRI functional connectivity inlocalizing motor areas.Results rs-fMRI was used for localizate motor areas of18cases, image acquisitionsatisfied in17cases,1case was not successful.We chose region of interesting from bormdann4to construct functional connectivity：the primory motor area and motor area of ipsilateraloccurred obvious functional connectivity, the functional connectivity of contralatral cerebralhemispheres was less than ipsilateral cerebral hemispheres.18cases of tumor were resectionin14cases, subtotal resection in3cases, most resection in1case.The intraoperative direct electric cortical stimulation showed good correlation with resting-state fMRI activation in92.9%of cases.Conclusion rs-fMRI can be performed even when the patient is unable to cooperatewith the functional task, used to guide individualized preoperative surgical programdevelopment.rs-fMRI was a high sensitive and reliable technique to locate the position of themotor areas and their spatial relation with adjacent tumor, especially for the presurgicalplanning in patients with central area brain tumor.