Vol 47, No 6 (2013)

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

Michał Tymowski1, Krzysztof Majchrzak1, Barbara Bobek-Billewicz2, Piotr Ładziński1, Henryk Majchrzak1
DOI: 10.5114/ninp.2013.39072
Neurol Neurochir Pol 2013;47(6):547-554.

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 neuronavigation system to the results of classical operative treatment.

Material and methods

The studied group comprised 28 patients with a tumour located in the sensory-motor cortex area who underwent surgery guided with fMRI and the neuronavigation 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.

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Neurologia i Neurochirurgia Polska