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Alterations in gyral contour made it difficult to identify the motor cortex thought to be near an arteriovenous malformation (AVM) in a 24-year-old man considered for stereotactic radiosurgery. Functional imaging in three modalities was performed preoperatively to compare the reliability of localization using functional magnetic resonance imaging (fMRI) on a conventional scanner with positron emission tomography (PET) and magnetoencephalography (MEG). Similar tasks were used for each imaging modality in an attempt to activate and identify the sensory and motor cortex. Data from all three modalities converged for the sensory task, and fMRI and PET data converged for the motor task. The right hemisphere motor strip was localized adjacent and anterior to the AVM. These data were used in planning the radiosurgery isodose configuration to the AVM in order to reduce the irradiation of motor cortex parenchyma. A postoperative fMRI study was also performed using newer techniques to reduce head motion artifact and to improve signal-to-noise ratio. The data confirmed the conclusions derived from the preoperative evaluations. This study demonstrates how conventional MRI scanners can be used for functional studies of use in surgical planning.

Original publication

DOI

10.1002/(SICI)1522-712X(1995)1:4<191::AID-IGS1>3.0.CO;2-5

Type

Journal article

Journal

J Image Guid Surg

Publication Date

1995

Volume

1

Pages

191 - 197

Keywords

Adult, Humans, Intracranial Arteriovenous Malformations, Magnetic Resonance Imaging, Magnetoencephalography, Male, Motor Cortex, Radiosurgery, Somatosensory Cortex, Stereotaxic Techniques, Tomography, Emission-Computed