Application Of Intraoperative Magnetic Resonance Imaging And Functional Neuronavigation In Microsurgery For Lesions Near Language Associated Areas

Objective:To explore the clinical value of intraoperative magnetic resonance imaging and functional neuronavigation in microsurgery for lesions near language associated areas. Methods:61 right-handed patients with lesions near language associated areas were operated in a 1.5T intraoperative magnetic resonance imaging suite and a microscope-based functional neuro-navigation. Both Blood Oxygen Level Dependent (BOLD) and Diffusion Tensor Imaging (DTI) were used for functional navigation. All patients were divided into 2 groups according to the location of lesions:Group A (lesions near left posterior inferior frontal gyrus) and Group B(lesions near left posterior superior temporal gyrus). The Aphasia Quotient(AQ) of all patients were obtained by Western Aphasia Battery (WAB) before operation and 2 weeks after the operations.Results:33 patients obtained normal AQ score(AQ≥93.8) before operation. There was no significant difference between AQpostop and AQpreop in these patients(P>0.05). The AQpostop of 28 patients who had lower AQ score(AQ<93.8) before operation increased significantly compared with the AQpreop (P<0.01). Language function worsened in 14 patients (23.0%) 2 weeks after operations and only 2 patients(3.2%) had a persistent language deficit 6 months after operation. Among 61 patients,41 patients underwent gross resection and 20 patients received subtotal resection. The DeltaAQ(△AQ=AQpostop-AQpreop) had no correlation with the resection level of lesion.△AQ of Group A was higher than that of Group B. Conclusions:Intraoperative magnetic resonance imaging and functional neuronavigation can discover the relationship between lesions and language cortex and fasciculus. It is helpful for retaining the language function after operation for the patients with lesions near the language associated areas.