BOLD-fMRI Application In The Surgical Treatment Of Brain Tumors In Or Around Functional Areas Of Language

Objective To study the method of preoperative localization of language areas with Bold-fMRI in patients with brain tumors in or around functional areas of language ,combined with intraoperative cortical stimulation of language areas with awaken surgery. Methods oxygen dependent functional magnetic resonance imaging (BOLD-fMRI) technology, using the block design and reciting task to activate broca area and the paragraph comprehension task to activate wernicke area, calculated cerebral laterality index (LI) to determine the dominant hemisphere . using of the cortical stimulation (ECS) to localizate language areas under general anesthesia wake up in patients with indications of awaken surgery , and compared to preoperative localization of language with BOLD-fMRI, microscopic removal of lesions more than 10mm security Away from the language areas.. Results BOLD-fMRI was used for localizate broca or wernicke area of 11 cases, image acquisition satisfied in 10 cases, 1 case was not successful. Intraoperative wake-up and electrical stimulation of language areas in 2 cases,. Lesion resection in 6 cases, subtotal resection in 3 cases, subtotal in 2 cases. Language function improved significantly after surgery in 4 cases, unchanged in 6 patients, transient sensory aphasia in 1 case, deterioration of language function does not appear . Conclusion BOLD-fMRI can be used as non-invasive , precise positioning and effective method for localizating the language areas the language and assess the dominant hemisphere; preoperative localization of language areas with BOLD-fMRI , microscopic tumor resection and the protection of the cortex of Language areas under intraoperative cortical stimulation has a good clinical value, can increase the extent of tumor resection and reduce postoperative morbidity and the lack of language features, to improve quality of life of the patients.