3. fMRI en DTI
Significant effect op chirurgische planning
Agressievere benadering1
Bevestiging irresectabiliteit1
Petrella JR, Shah LM, Harris KM, Friedman AH, George TM, Sampson JH, Pekala JS, Voyvodic JT. Preoperative
1
Functional MR Imaging Localization of Language and Motor Areas: Effect on Therapeutic Decision Making in
Patients with Potentially Resectable Brain Tumors. Radiology 2006;3:793-802.
5. DTI
Ori谷ntatie witte stof banen
Anisotropische eigenschappen
Watermoleculen in axonen diffunderen meer
in de lengterichting dan loodrecht
Myeline omgeven banen
6. De praktijk
1.5 T MRI (Siemens Avanto)
fMRI en DTI radioloog en neurochirurg
7. De praktijk
Specifieke corticale gebieden
Motorisch
Spraakcentrum
Visueel
11 fasen
6 rust
5 stimulatie
30 tot 60 minuten
15. Conclusie
Met 1.5 T adequate fMRI en DTI preoperatief
Combinatie van fMRI en DTI betere weergave
kritieke corticale gebieden en zenuwbanen
Goede samenwerking belangrijk voor kwaliteit
en beoordeling
16. Referenties
1. Petrella JR, Shah LM, Harris KM, Friedman AH, George TM, Sampson JH, Pekala
JS, Voyvodic JT. Preoperative Functional MR Imaging Localization of Language and
Motor Areas: Effect on Therapeutic Decision Making in Patients with Potentially
Resectable Brain Tumors. Radiology 2006;3:793-802.
2. Wilkinson ID, Romanowski CAJ, Jellinek DA, Morris J, Griffiths PD. Motor
functional MRI for pre-operative and intraoperative neurosurgical guidance. The
British Journal of Radiology 2003;76:98-103.
3. Ten Donkelaar HJ. Clinical Neuroanatomy. Brain Circuitry and Its Disorders.
2011:107-131.
4. Krasnow B, Tamm L, Greicius MD, Yang TT, Glover GH, Reiss AL, Menon V.
Comparison of fMRI activation at 3 and 1.5 T during perceptual, cognitive and
affective processing. NeuroImage 2003;18:813-826.
5. Voss HU, Zevin JD, McCandliss BD. Functional MR Imaging at 3.0 T versus 1.5 T:
A Practical Review. Neuroimaging Clinics of North America 2006;16:285-297.
17. Met dank aan
B.M. Wiarda, radioloog MCA
W.F. Tan, neurochirurg MCA
P.R. Algra, radioloog MCA