Magnetic source imaging combined with image-guided frameless stereotaxy: a new method in surgery around the motor strip.

Abstract:

OBJECTIVE:In this study, information about the localization of the central sulcus obtained by magnetic source imaging (MSI) was intraoperatively translated to the brain, using frameless image-guided stereotaxy. In the past, the MSI results could be translated to the surgical space only by indirect methods (e.g., the comparison of the MSI results, displayed in surface renderings, with bony landmarks or blood vessels on the exposed brain surface). METHODS:Somatosensory evoked fields were recorded with a MAGNES II biomagnetometer (Biomagnetic Technologies Inc., San Diego, CA). Using the single equivalent current dipole model, the localization of the somatosensory cortex was superimposed on magnetic resonance imaging with a self-developed contour fit program. The magnetic resonance image set containing the magnetoencephalographic dipole was then transferred to a frameless image-guided stereotactic system. Intraoperatively, the gyrus containing the dipole was identified as the postcentral gyrus, using neuronavigation, and the next anterior sulcus was regarded as the central sulcus. With intraoperative cortical recording of somatosensory evoked potentials, this assumption was verified in each case. RESULTS:In all cases, the preoperatively assumed localization of the central sulcus and motor cortex with MSI agreed with the intraoperative identification of the central sulcus using the phase reversal technique. CONCLUSION:The combined use of MSI and a frameless stereotactic system allows a fast orientation of eloquent brain areas during surgery. This may contribute to a safer and more radical surgery in lesions adjacent to the motor cortex.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Ganslandt O,Steinmeier R,Kober H,Vieth J,Kassubek J,Romstöck J,Strauss C,Fahlbusch R

doi

10.1097/00006123-199709000-00023

subject

Has Abstract

pub_date

1997-09-01 00:00:00

pages

621-7; discussion 627-8

issue

3

eissn

0148-396X

issn

1524-4040

journal_volume

41

pub_type

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