The use of functional magnetic resonance imaging in reducing a risk of postoperative neurological deficits in the patients with brain tumour

Neurol Neurochir Pol. 2013 Nov-Dec;47(6):547-54. doi: 10.5114/ninp.2013.39072.

Abstract

Background and purpose: The purpose of the study was to compare the results of operative treatment of tumours located in the sensory-motor cortex guided with functional magnetic resonance imaging (fMRI) combined with the neuro-na-vigation system to the results of classical operative treatment.

Material and methods: The studied group comprised 28 pa-tients with a tumour located in the sensory-motor cortex area who underwent surgery guided with fMRI and the neuro-na-vigation system. A control group comprised 30 patients with the same clinical diagnosis, operated on without functional neuronavigation.

Results: The use of functional neuronavigation allowed for an 18% reduction in the intensity of neurological deficits after surgical treatment in patients from the studied group, compared to the subjects from the control group (p = 0.0001). In the patients with diagnosed high-grade glioma, improvement in the neurological condition in the studied group was 16% (p = 0.03). The initial neurological condition and the results of surgical treatment in patients with a tumour located less than 5 mm from the sensory-motor cortex, determined in fMRI examination, are worse than in patients with a tumour located more than 5 mm.

Conclusions: In patients with a diagnosed brain tumour in the sensory-motor cortex who have neurological deficits, fMRI provides valuable imaging data on active areas. Tumour location of more than 5 mm from the fMRI active area of the sensory-motor cortex is connected with a considerably lower risk of postoperative neurological deficits. Removing a tumour in the sensory-motor cortex region, guided with fMRI and the neuronavigation system, considerably lowers the risk of postoperative development or exacerbation of neurological deficits.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Brain Neoplasms / pathology*
  • Brain Neoplasms / surgery*
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Motor Cortex / pathology*
  • Motor Cortex / surgery*
  • Neurologic Examination
  • Neuronavigation / methods
  • Postoperative Complications / prevention & control*
  • Postoperative Period
  • Surgery, Computer-Assisted / methods
  • Young Adult