论文部分内容阅读
目的研究利用三维重建脑表面成像辨识中央前回的方法及其可靠性。方法难治性癫痫经术前评估需要进行颅内电极植入的病例12例,术前行3T磁共振结构像扫描及运动功能磁共振测试,颅内电极植入后行头颅CT扫描。利用磁共振数据,用Brainvoige软件进行脑表面三维重建,并与硬膜下电极CT融合。根据中央前回的形状走行特点,在重建的脑表面上标记中央前回,进而辨识标记术区中央前回。用皮层电刺激和功能磁共振验证所标记中央前回的可靠性。结果 12例均进行了脑表面三维重建,并标记出了中央前回,硬膜下电极CT电极点与三维脑表面融合。统计中央前回上电极点101个,电刺激运动响应73个,响应率72%;对照组中央前回前1cm(统计中央前沟前2个电极范围),130个电极,17个电极有运动响应,响应率13%,p值小于0.05;功能磁共振手的运动100%中央前回有激活,中央前回前无明显激活。电刺激及功能核磁均验证了本研究方法确定中央前回准确可靠。结论脑表面成像辨识中央前回准确可行,可以利用各初级运动皮层分布的距离进行详细的初级运动皮层的绘制定位。
Objective To study the method of identifying central frontal gyrus by three-dimensional reconstruction of brain surface and its reliability. Methods Twelve patients with intractable intracranial electrode implantation were enrolled in the preoperative evaluation of intractable epilepsy. The 3T magnetic resonance imaging and magnetic resonance imaging were performed preoperatively and cranial CT scan was performed after intracranial electrode implantation. Three-dimensional reconstruction of the brain surface was performed using Brainvoige software using magnetic resonance data and fused with a subdural electrode CT. According to the shape of the central front go back to the characteristics of the mark in the reconstruction of the brain back to the central front, and then identify the central front of the marker area. Cortical stimulation and functional magnetic resonance were used to verify the reliability of the labeled central anterior regression. Results All the 12 patients underwent 3D reconstruction of the brain surface and marked the central frontal gyrus. The electrode points of the subdural electrode CT fused with the three-dimensional brain surface. In the control group, 1cm before the central gyrus (statistical range of 2 electrodes in the antero-foregut), 130 electrodes and 17 electrodes had motor response, Response rate of 13%, p-value of less than 0.05; functional magnetic resonance hand movement 100% of the central front to activate, no significant activation before the central retrospective. Both the electrical stimulation and the functional NMR prove that the method of this study confirms that the central anterior return is accurate and reliable. Conclusion It is feasible and accurate to identify the central frontal gyrus by imaging the brain surface. Detailed mapping of the primary motor cortex can be made by using the distance distribution of the primary motor cortex.