Application Of MR Functional And Neuro-fiber Track Imaging On Motion-related Intracranial Tumors

PART ISubtitle: Evaluation of hand movement on patients with intracranial tumors involving motor cortex by fMRIPurpose: To investigate hand movement representation area reconstruct in patients with intracranial tumor involving motor cortex using fMRI. Methods: 25 patients with intracranial tumor involving the motor cortex or its white matter pathway and 10 normal volunteers were enrolled in the study. All of the subjects are right-hand dominant. The study was performed on a 1.5T MR scanner with an 8 channel phase-array head coil, using single-shot EPI-BOLD sequence. The protocol was block paradigms, repeating "activation" and "rest" 5 times and each of them lasted 20sec. The motion-related function area was evaluated under the conditions of bilateral hand-clench and finger-tapping respectively. The fMRI data were analysed using the Brainwave? software and SPM software on PC.Results: On 10 volunteers, the contralateral primary motor cortex was showed activation during hand-clench and finger-tapping movement. The activated areas of the dominant right hands were larger than those of the left hands. The secondary motor area was not activated during hand-clench movement, while it showed activation on 5 cases during left finger-tapping movement and 7 cases during right finger-tapping movement. The primary motor area were located in contralateral precentral gyrus in 25 patients during hand-clench movement and 20 patients during finger-tapping movement. The activated primary motor areas were smaller in the contralateral hand movement than ispilateral hand movement of the patients and volunteers. There were more secondary motor area acvtivated on patients than on volunteers. There were more secondary motor area detected in finger-tapping than hand-clench movement in patients study.Conclusion: Function reconstruct was detected on patients with tumors involvingthe primary motor cortex or its pathway. The primary motor area ipsilateral to the tumors were smaller than its contralateral counterpart and the volunteers and there were more the secondary motor area were detected in patients than the volunteer group. There were more the secondary motor area were detected in finger-tapping than hand-clench movement in patients group.PartnSubtitle: Combined Application of Diffusion Tensor Imaging and Functional MRI in tumor involving motor cortexPurpose: To show the relationship between tumor > activated area and its fiber tract using fMRJ and diffusion-tensor imaging (DTI) techniques.Methods: 25 patients with intracranial tumor involving the motor cortex or its white matter pathway were enrolled in the study. All of them are right-hand dominant. The study was performed on a 1.5T MR scanner with an 8-channel phase-array head coil. DTI was acquired using SE-EPI sequence, applying the diffusion gradients (b=1000s/mm2) on 15 different directions. FMRI was acquired using single-shot EPI-BOLD sequence. The protocol was block paradigms, repeating "activation" and "rest" 5 times and each of them lasted 20sec. The motion-related function area was evaluated under the conditions of bilateral hand-clench and finger-tapping movements, respectively. The fMRI data were analysed using the Brainwave? software and SPM software on PC. And both DTI and fMRI data were fused using Volume-one software.Results: The primary motor areas ipsilateral to the tumors were activated oh 25 patients during hand-clench movement and 20 patients during finger-tapping movement. The activated areas were compressed on 5 cases of meningiomas. Of 20 intra-axial tumors, the activated area of 2 cases with tumor located in the internal capsule and thalamus showed no involvement. The other 18 cases could be classified into 3 groups: 1) the activated area showed no displacement or distortion, 3 cases;2) the activated areas were displaced or distorted by the adjacent tumors, 8 cases;3) the activated area were destructed, displaced or encased by the tumors, 7 cases. The spatial relationship between white matter fiber tract and meningioma was simple displacement while it was much more complicated in intra-axial tumors: 1 case showed normal pattern, 2 cases showed simple displacement and the other 17 cases showed infusion and destruction.Conclusion: Combined application of fMRI and DTI could show the spatialrelationship between the tumors > activated area and fiber tracts.PART IIISubtitle: Evaluation of hand movement with fMRI in postsurgical patients with intracranial lesion involving motor cortexPurpose: To investigate motor hand representation area reconstruction after neurosurgery using fMRI.Methods: 12 patients with tumors involving the motor cortex accepted fMRI examination with 1 week after tumors resection. Of them, 3 cases repeated the fMRI examination 3 months, 1 case repeated it after 3 and 6 months, 1 case repeated it after 3, 7 and 13 months after the surgery. The activated areas were evaluated and compared to the contralateral counterparts and the data analysis were performed on GE brainwave software and SPM software.Results: Compared to the pre-surgery, 5 cases with contralateral extremities temporary weakness but recovery within lweek showed enlarged activated areas. Of the 7 cases with contralateral extremities weakness but no recovery within lweek, 5 cases showed smaller activated areas, 1 case kept the same and 1 case showed enlarged when compared to the pre-surgical examination. 5 cases with contralateral extremities temporary weakness recovery in 3 months and 2 cases recovered in 6 and 7 months showed enlarged activated primary motor cortex areas. 1 showed the same area after 13 months when compared to 7 months after surgery. 12 of them showed secondary motor cortex activation, especially in suprafrontal gyrus and infratemporal gyrus and they disappeared as the extremities weakness recovery.Conclusion: The primary motor area activation were correlated to the extremities recovery after tumors resection. The secondary motor area activation disappeared as the extremities symptoms recovered.