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Titolo:
THE ROLANDIC LINE - A SIMPLE BASE-LINE FO R CENTRAL REGION IDENTIFICATION - MRI STUDY AND FUNCTIONAL VALIDATION
Autore:
DEVAUX B; MEDER JF; MISSIR O; TURAK B; DILOUYA A; MERIENNE L; CHODKIEWICZ JP; FREDY D;
Indirizzi:
CTR HOSP ST ANNE,SERV NEUROCHIRURG,1 RUE CABANIS F-75014 PARIS FRANCE CTR HOSP ST ANNE,SERV NEURORADIOL F-75014 PARIS FRANCE CTR HOSP ST ANNE,NUCL MED SERV F-75014 PARIS FRANCE
Titolo Testata:
Journal of neuroradiology
fascicolo: 1, volume: 23, anno: 1996,
pagine: 6 - 18
SICI:
0150-9861(1996)23:1<6:TRL-AS>2.0.ZU;2-6
Fonte:
ISI
Lingua:
FRE
Soggetto:
CORTEX; LOCALIZATION; ASYMMETRIES; BRAIN; SULCUS; SYSTEM;
Keywords:
BRAIN, ANATOMY; CENTRAL SULCUS; STEREOTAXY; MAGNETIC RESONANCE IMAGING; DEEP BRAIN STIMULATIONS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
33
Recensione:
Indirizzi per estratti:
Citazione:
B. Devaux et al., "THE ROLANDIC LINE - A SIMPLE BASE-LINE FO R CENTRAL REGION IDENTIFICATION - MRI STUDY AND FUNCTIONAL VALIDATION", Journal of neuroradiology, 23(1), 1996, pp. 6-18

Abstract

Introduction: The identification of the central region - i.e. the central sulcus, the pre- and post-central gyri, the para-central lobule -on MRI and angiographic images may be necessary prior to stereotacticprocedures such as biopsies or resection of centrally located tumors,depth electrode recordings for presurgical evaluation of drug-resistant epilepsises, or radiosurgery of arteriovenous malformations. Stereotactic methods, such as the Talairach's proportional grid based on thebiocommissural system, demonstrated the statistical position of the central sulcus according to the Ac-Pc, Vac and Vpc baselines. However, the course and the spatial position of this sulcus have remarkable individual differences that sometimes make the sulcus difficult to identify on serial sagittal MRI or lateral angiographic images. In order to facilitate this identification, the authors propose a new oblique baseline, the rolandie (R) line. Material and Methods: The stereotactic MRI and angiography of 22 patients were reviewed for this study. Eleven of these patients had stereotactic biopsies for a low-grade tumor located in the central region., while eleven others had multiple intracerebral electrodes implantation and depth EEG recording (SEEG: stereoelectroencephalography) in the presurgical evaluation of drug-resistant partial epilepsy, prior to epileptogenic cortex resection. The Ac-Pc, Vac, Vpe base-lines and segments of the central sulcus were drawn from the mid-sagittal and lateral T1-weighted MRI images and reported on an individual graph. Surface and deep margins as well as axis of the central sulcus were also reported along with corpus callosum baselines as defined by Olivier et al. : horizontal plane, anterior and posterior callosal planes. The rolandic line was then traced from the graph : it joined the intersection point between the anterior callosal plane and an orthogonal line passing through the floor of the temporal fossa, and the intersection point between posterior callosal plane and an orthogonal line passing through the top of the hemisphere. The rolandic line was then superimposed on any sagital MRI image or lateral stereotactic angiographic film. Finally, the spatial position of electrode contacts through which electrical stimulations elicited motor and/or sensory responses, either from central electrode implanted for motor fibers identification prior to stereotactic biopsies or from SEEG electrodes implanted for epileptogenic zone identification and cortical mapping: was reported on the individual graph. Angular and linear measurements were taken from the graph, between the rolandic line, the central sulcus axis, the Ac-Pc and callosal baselines, and the central sulcus limits (top, bottom, anterior and posterior margins). Results: Graph measurements indicated that the rolandic line was significantly closer to the inferior part of the central sulcus than to its superior part (average distance between the line and the inferior point of the sulcus: 1.86 +/- 1.87 mm; average distance between the line and the superior point of the sulcus: 4.5 +/- 2.3 mm;p < 0.001 - t test); similarly, the rolandic line was closer to the deep margin of the sulcus rather than to its superficial border (average distance between the line and the most anterior point of the sulcus : 11.43 +/- 3.16 mm; average distance between the line and the most posterior point of the sulcus : 7.95 +/-4.14 mm; p < 0.01 - t test). In 90% of the cases, the rolandic line followed the deep or middle part of the sulcus. with an average angle of 4.18 degrees +/- 2.53 degrees between the line and the sulcus axis. The spatial position of the electrode contacts that elicited motor/or sensory responses to stimulations correlated topographically well in all cases with the position of the motor and sensory fibers defined according to the central sulcus, baselines and reference to stereotactic atlases. Discussion : The central sulcus appears symmetrical in both hemispheres of a single brain, but individual variations in course, three-dimensional pattern, and branching of the sulcus may make it difficult to identify on sagittal or axial MRI images, especially for its inferior part. Reference to statistical baselines, such as those definedby Talairach er al. (bicommissural Ac-Pc reference system and proportional grid), may help in the sulcus identification, as most of the sulcus course lies obliquely between Ac and Pc lines. Olivier er al. use the corpus callosum for MRI and angiographic identification of the central region, and demonstrated that the inferior part of the central sulcus reached the mid-callosal plane. Using telencephalic landmarks, such as corpus callosum outlines, depth of the temporal fossa and brain's height, the rolandic line gives the central sulcus axis with minimalerror and follows either deep. middle or superficial margin of the sulcus in all cases. This line can be routinely traced from mid-sagittalMRI or lateral angiographic images for identification of the different sulcal segments as well as the central vascular lamina. Functional MRI and PET-scan currently allows for noninvasive functional mapping ofmotor and sensory cortex; functional images could be combined with 3-D MRI anatomical images for direct identification of the central region. Such integrated images still need to be validated; the rolandic line may help in this validation. Conclusion : The rolandic line appears to be reliable in localizing as well as giving the axis of the centralsulcus on any lateral cerebral image. Easily displayed on sagittal MRI and lateral angiographic images, the rolandic line is more accurate for central sulcus identification than Vac and Vpc lines from the bicommissural system. Current refinements of MRI permits easy direct identification of the central region in most cases, along with functional mapping through functional MRI; reference to atlases, templates or proportional grid system for cortical localization thus seems unnecessary. However, in some cases, due to individual variability of the central sulcus, reference to the rolandic line may help in central sulcus identification. Therefore the rolandic line must be considered a guide in difficult cases rather than a new baseline for statistical localization of the central region.

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Documento generato il 05/12/20 alle ore 12:16:53