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[Application of intraoperative magnetic resonance imaging and functional neuronavigation in microsurgery for lesions near language-related brain regions].

OBJECTIVE
To explore the clinical value of intraoperative magnetic resonance imaging (MRI) and functional neuronavigation in the preservation of the language function during microsurgery for lesions near language-related brain regions.


METHODS
Sixty-one right-handed patients underwent microsurgical resection of the lesions near the language-related brain regions with the assistance of intraoperative MRI and blood oxygen level- and diffusion tensor imaging-based functional neuronavigation. The patients were divided into 2 groups according to the location of the lesions, namely group A with lesions near the left posterior inferior frontal gyrus and group B with lesions near the left posterior superior temporal gyrus. The aphasia quotient (AQ) of all patients were obtained using Western Aphasia Battery (WAB) before and 2 weeks after the operation.


RESULTS
In the 33 patients with a normal AQ score (≥93.8) before the operation, the AQ score underwent no significant changes after the operation (P>0.05). Twenty-eight patients had lowered AQ scores (〈93.8) preoperatively, which were improved significantly after the operation (P<0.01). At 2 weeks after the operation, the language function worsened in 14 patients (23.0%), and only 2 (3.2%) showed a persistent language deficit at 6 months. Of the 61 patients, radical resection of the lesions was achieved in 41 and subtotal resection in 20 patients. The variation of AQ scores after the operation was not found to correlate to the degree of lesion resection, and the patients in group A showed a greater AQ variation than those in group B.


CONCLUSIONS
Intraoperative MRI and functional neuronavigation can well demonstrate the structural relations between the lesions, the cortical areas and the fasciculi related to language functions, thus helping to better preserve the language function during microsurgical lesion resection in patients with lesions near language-related brain regions.