Accurate Preoperative Identification of Motor Speech Area as Termination of Arcuate Fasciculus Depicted by Q-ball Imaging Tractography.
Accurate Preoperative Identification of Motor Speech Area as Termination of Arcuate Fasciculus Depicted by Q-ball Imaging Tractography.
复制标题
术前准确识别运动言语区作为 Q 球成像纤维束成像描绘的弓状束的终止。
DOI：
10.1016/j.wneu.2022.05.041
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发表时间：
2022
影响因子：
2
通讯作者：
N. Saito
中科院分区：
文献类型：
--
作者：
T. Koike;Shota Tanaka;Taichi Kin;Yuichi Suzuki;Shunsaku Takayanagi;Hirokazu Takami;Kazuha Kugasawa;Shohei Nambu;Takaki Omura;Erika Yamazawa;Yoshihiro Kushihara;Yasuyuki Furuta;R. Niwa;Katsuya Sato;T. Uchida;Yasuhiro Takeda;S. Kiyofuji;Toki Saito;H. Oyama;N. Saito
背景：神经束造影是术前预测皮质功能区分布的一种方法。弥散张量纤维束造影（DTT）在临床实践中常用，但已知在描绘交叉纤维方面存在局限性，而q球成像纤维束造影（QBT）可以克服这一局限性。我们的目的是比较这两种方法的可靠性，基于在清醒手术中由束束造影描绘的弓形束与直接皮层刺激之间的空间相关性。方法在本研究中，15例胶质瘤患者接受直接皮质刺激的清醒手术。术前用三维计算机图形模型描绘束状图，并使用我们的新型混合现实技术将其与实际大脑皮层的照片相结合。将DTT或QBT所描绘的弓形束终止与直接皮层刺激的结果进行比较，并计算语言相关脑回的敏感性和特异性：三角部、包部、腹侧中央前回和额叶中回。结果qbt检测包膜部的灵敏度明显高于DTT，假阳性率明显低于DTT。另一个脑回也有同样的趋势。结论sqbt比DTT对运动言语区识别更可靠，在脑肿瘤手术中具有临床应用价值。
BackgroundTractography is one way to predict the distribution of cortical functional domains preoperatively. Diffusion tensor tractography (DTT) is commonly used in clinical practice, but is known to have limitations in delineating crossed fibers, which can be overcome by Q-ball imaging tractography (QBT). We aimed to compare the reliability of these 2 methods based on the spatial correlation between the arcuate fasciculus depicted by tractography and direct cortical stimulation during awake surgery.MethodsIn this study, 15 patients with glioma underwent awake surgery with direct cortical stimulation. Tractography was depicted in a three-dimensional computer graphic model preoperatively, which was integrated with a photograph of the actual brain cortex using our novel mixed-reality technology. The termination of the arcuate fasciculus depicted by either DTT or QBT and the results of direct cortical stimulation were compared, and sensitivity and specificity were calculated in speech-associated brain gyri: pars triangularis, pars opercularis, ventral precentral gyrus, and middle frontal gyrus.ResultsQBT had significantly better sensitivity and lower false-positive rate than DTT in the pars opercularis. The same trend was noted for the other gyri.ConclusionsQBT is more reliable than DTT in identification of the motor speech area and may be clinically useful in brain tumor surgery.