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Clinical Functional MRI pp 1–12Cite as

Presurgical Functional MRI and Diffusion Tensor Imaging

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Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

Abstract

Functional magnetic resonance imaging (fMRI) provides noninvasive localisation and lateralisation of specific brain functions by measuring local hemodynamic changes coupled to neuronal activation. Different magnetic properties of oxygenated (diamagnetic) and deoxygenated (paramagnetic) hemoglobin are exploited to generate the blood oxygen level dependent (BOLD) contrast. Diffusion tensor magnetic resonance imaging (DTI) measures anisotropic (directional) diffusion of protons along myelinated fibers and thereby provides detailed information on the white matter architecture. Specific white matter tracts can be reconstructed using diffusion tensor tractography (DTT). During the last two decades both novel MR-modalities have revolutionised the imaging research on human brain function and structural connectivity under physiological and pathological conditions.

Task-based presurgical fMRI in patients with brain tumors or epilepsies represents the best established and validated clinical application. Essential cortical motor and language areas can be localised and the language dominant hemisphere can be determined prior to treatment. DTI and DTT provide complimentary data on important white matter connections, e.g., the pyramidal tract and arcuate fascicle. This imaging information is indispensible to establish the best possible treatment for each individual patient, and to achieve the ultimate goal of surgery: function preserving complete or most radical removal of the pathology. To this end fMRI and DTI are integrated meaningfully into functional neuronavigation. While promising, resting-state fMRI is currently still under initial clinical investigation.

The responsible clinical application requires standardised imaging and data processing as well as a profound knowledge of the imaging techniques employed, the underlying functional neuroanatomy, physiology and pathology, neuroplastic alterations, influencing factors, artifacts, pitfalls, validity and limitations. Finally, information on other functional neuroimaging modalities and multimodal integration is essential.

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  1. Division of Diagnostic and Interventional Neuroradiology, University Hospitals Basel, Petersgraben 4, Basel, CH 4031, Switzerland

    Christoph Stippich MD (Professor and Division Head)

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    Christoph Stippich

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Stippich, C. (2015). Presurgical Functional MRI and Diffusion Tensor Imaging. In: Stippich, C. (eds) Clinical Functional MRI. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-45123-6_1

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