POVZETEK

Uvod in namen: Funkcijsko magnetnoresonančno (fMR) slikanje kot neinvazivna diagnostična metoda omogoča slikanje delovanja možganov, na podlagi česar lahko npr. določimo položaj motoričnega področja za roko in področij za govor ter ugotovimo, katera možganska polobla je dominantna za govor. To slikanje temelji na merjenju razlike v magnetnih lastnostih oksigeniranega in deoksigeniranega hemoglobina v krvi. Namen članka je predstaviti metodo fMR in njeno klinično uporabnost pri bolnikih z žariščnimi okvarami možganov.Metode: Metode, ki smo jih uporabili, so pregled literature o fMR slikanju, sodelovanje pri fMR preiskavah in retrospektivni pregled baze bolnikov z žariščnimi okvarami možganov, pri katerih smo to slikanje opravili med oktobrom 2009 in januarjem 2013. V študijo smo vključili 18 bolnikov, od tega 9 žensk in 9 moških v starosti od 18. do 55. leta. Slikanje smo
opravili z magnetnoresonančnim aparatom Magnetom Trio, A Tim System 3.0T. Pridobljene magnetnoresonančne slike smo s pomočjo računalniškega programa MRIconvert najprej iz zapisa DICOM pretvorili v zapis Nifty. Slike smo nato obdelali in statistično analizirali s programskim paketom SPM (Statistical Parametrical Mapping), ki teče v okolju MATLAB. Rezultate smo prikazali s programom MRIcro. Rezultati: Prikazana so motorična možganska področja za roko in govor ter opredeljena govorna dominanca. Za govor je bila pri 76% bolnikov dominantna leva polobla, pri 24% pa je šlo za obojestransko dominanco. Nihče od bolnikov ni imel
desnostranske dominance. Razprava: Pri bolnikih z žariščnimi okvarami možganov fMR slikanje omogoča prikaz in lokalizacijo pomembnih možganskih področij. To je lahko koristna informacija za nevrokirurga, ki skuša ta področja med operacijo možganov ohraniti nepoškodovana in tako omogočiti bolnikom čim boljše pooperativno okrevanje. Zaključek: Rezultati raziskave so pokazali, da je bila pri večini
bolnikov za govor dominantna leva možganska polobla. Uporaba fMR slikanja je zelo raznolika, saj se uporablja tako v klinične kot v raziskovalne namene.

ABSTRACT

Introduction and purpose: Functional magnetic resonance imaging (fMRI) is a non-invasive diagnostic method for brain function imaging. It can be used to determine the location of hand motor region, cortical language areas and hemispheric language dominance. This type of imaging is based on measuring the difference in the magnetic properties of oxygenated and deoxygenated haemoglobin in the blood. The purpose of this article is to present the method of functional magnetic resonance imaging and its clinical application in patients with focal brain lesions. Methods: Literature review, active participation in fMRI investigations and retrospective review of the database of patients with focal brain lesions, who underwent fMRI during the period from October 2009 to January 2013. The study included 18 patients (9 women and 9 men) aged 18 to 55 years. The imaging was performed by Magnetom Trio, A Tim System 3.0T and the MRIconvert computer program was used to convert the DICOM data to Nifty data. The
images were processed and statistically analysed by SPM (Statistical Parametrical Mapping) software that runs in MATLAB environment. The results were shown by the MRIcro
programme. Results: We showed the cortical motor regions for hand and speech and assessed the hemispheric language dominance. In 76 % of the patients, the left hemisphere was dominant for speech, whereas in 24 % both hemispheres were dominant. None of the patients showed the right-sided dominance.Discussion: fMRI shows and localizes the important brain areas in patients with focal brain lesions. This may be useful for neurosurgeons, so that they can avoid these areas during brain surgery and provide optimal post-operative patient recovery. Conclusion: According to the results, the left cerebral hemisphere was dominant for speech in most of the patients. fMRI imaging is not only used for clinical but also for research purposes.