Neuroimaging and Interventional Radiology

Biography

Biography: Rafael Martins Ferreira

Abstract

Functional Magnetic Resonance Imaging (fMRI) is a technique that takes advantage of the diferences in magnetic susceptibility between oxyhemoglobin and deoxyhemoglobin. Once the goal of neurosurgery is to maximize patient safety and to minimize residual tumor, fMRI may be an alternative, non-invasive and reproducible tool for assessing potential risk of dysfunction resulting from brain ressection near eloquente cortex. Tumoral mass eff ects can distort normal cortical anatomy losing anatomical landmarks.

So fMRI studies with specific –tasks combines structural with physiological information and provides data helping in localizing cortex controlling language, motor, sensory, hearing and visual pathways , according to tumor region. In addition, many studies confirm the large individual variability in cortical localization of language and fmri data may aid in the determination of language laterality and localization of Wernicke’s and Broca’s areas in cases of temporo-parietal lesions. Althout fmri can show cortical signals, imaging the White matter bundle may be just as crucial. Therefore Diffusion Tensor imaging complements fMRI examinations and provides the surgeon with fi ber-tracking information. In summary, fMRI data can alter a neurosurgical approach to a tumor, indicates eloquent cortex in distorted areas, guide surgical resections or even emphasize too high risk in total tumor resection in other cases. Clinical cases showing such fMRI applications and a literature review about clinical outcomes is presented.