A Clinical Application Study Of Human Visual Cortex And Lesions In Visual Cortex By BOLD-fMRI

Objective By BOLD-fMRI to study the characteristics of the pixelnumber activated and the biggest signal strength changed of normalvisual cortex and visual cortex of patients with lesions at occipital lobe.To educe important roles to the patients with lesions at occipital lobe inthe clinical diagnosis,pre-surgical risk valuation,the guiding surgicaloperation and the monitering pro-surgical recovery.Materials and methods 30 normal volunteers,20 patients withlesions at occipital lobe were included in this test. Among 11 cases benignlesions(infarct of brain 6 cases, encephalomalacia 5 cases), 9 casesmalignant lesions(the glioma 6 cases,metastases 5 cases). The visualstimulation is come from a set of 8HZ red light emitting diodes which isplaced on a self-made binocular goggles. EPI sequence was used tocompare with two kinds of block design fMRI(ON and OFF) in visualcortexes. Use the SPM software to carry on realign, nomalize Gausssmooth statistics analytical processing to the original picture in theoff-line work station, educed the activatly mapping,volume and the thebiggest signal strength of the function area. The mapping and T1 imagingbe fold. The volume and the biggest signal strength data of function areause the SPSS. 11.5 software analysis, the comparison of each other of thedata adapted t examination. Crosstabs testing for count data. Pearsontesting for correlation analysis. Result 1.From the result of volunteers, we can fred the primaryvisual cortex is located at the bilateral calcarine Cortex, cuneus gyrus andlingual gyrus which is Area striata(Brodmann area 17).The activatedvoxels appear at the parastriate and peristriate also(Brodmann area 19 andarea 18). 2. Patients with lesions of the activated signal pixel number andthe biggest signal strength less than normal volunteers (P＜0.05) .3.Patients with lesions at the affected side of the activated signal pixelnumber and the biggest signal strength less than the contralesional side (P＜0.05) .4.Blurred vision with visual field defect of the activated signalpixel number and the biggest signal strength less than not visual fielddefect but with blurred vision(P＜0.05);Blurred vision with visual fielddefect of the activated signal pixel number and the biggest signal strengthless than normal of visual acuity(P＜0.05); Not visual field defect butwith blurred vision of the activated signal pixel number and the biggestsignal strength less than normal of visual acuity ,but not statisticallysignificant(P＞0.05).Conclusion 1. A preliminary location of visual cortex can beacquired through BOLD-fMRI. This location has good accordance withadditional anatomic functional areas. 2. BOLD-fMRI examinations canshow directly the basic appearance,anatomic position,volume and thebiggest signal strength of vision function area by appropriate activatlymode. 3.BOLD-fMRI can precisely show affect of lesions at occipital lobe on optic center.4. Difference in patients with lesions at occipital lobewith visual change of the activated signal pixel number and the biggestsignal strength,and occipital lobe lesions with visual field defect affectvisual cortex most obviously.