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01-10-2010 | Neuro

Identification of the pyramidal tract by neuronavigation based on intraoperative magnetic resonance tractography: correlation with subcortical stimulation

Authors: Alessandro Bozzao, Andrea Romano, Albina Angelini, Giancarlo D’Andrea, Luigi Fausto Calabria, Valeria Coppola, Luciano Mastronardi, Luigi Maria Fantozzi, Luigi Ferrante

Published in: European Radiology | Issue 10/2010

Abstract

Objective:

To demonstrate the accuracy of magnetic resonance tractograpghy (MRT) in localizing the cortical spinal tract (CST) close to brain tumours by using intraoperative electric subcortical stimulation.

Methods:

Nine patients with intra-axial brain tumours underwent neurosurgery. Planning was based on analysis of the course of streamlines compatible with the CST. After tumour removal, intraoperative MRT was reacquired. Sites at various distance from the CST were repeatedly stimulated to assess whether registered motor evoked potential (MEP) could be elicited. All patients were assessed clinically both pre- and postoperatively.

Results:

The motor function was preserved in all patients. In all patients intraoperative MRT demonstrated shift of the bundle position caused by the surgical procedure. The distance between the estimated intraoperative CST and the point of elicited MEP was 1 cm or less in all nine patients. At distances greater than 2 cm, no patient reported positive MEP.

Conclusion:

Intraoperative MRT is a reliable technique for localization of CST. In all patients MEP were elicited by direct subcortical electrical stimulation at a distance below 1 cm from the CST as represented by MRT. Brain shifting might impact this evaluation since CST position may change during surgery in the range of 8 mm.

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Title: Identification of the pyramidal tract by neuronavigation based on intraoperative magnetic resonance tractography: correlation with subcortical stimulation
Authors: Alessandro Bozzao
Andrea Romano
Albina Angelini
Giancarlo D’Andrea
Luigi Fausto Calabria
Valeria Coppola
Luciano Mastronardi
Luigi Maria Fantozzi
Luigi Ferrante
Publication date: 01-10-2010
Publisher: Springer-Verlag
Published in: European Radiology / Issue 10/2010
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-010-1806-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Identification of the pyramidal tract by neuronavigation based on intraoperative magnetic resonance tractography: correlation with subcortical stimulation

Abstract

Objective:

Methods:

Results:

Conclusion:

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective:

Methods:

Results:

Conclusion:

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