Aplicação clínica da RM funcional. Avaliação de funções motoras e fluência verbal.

Resumo

In this article we reviewed some examples of our experience in clinical applications of functional MRI (fMRI) in the motor and verbal fluency tasks evaluation. Seventeen patients with supratentorial cerebral pathology (5 arteriovenous malformations--AVMs, 2 meningiomas, 1 tuberculoma, 1 cortical tuberoma, 1 DNET, 2 cerebral metastases, 3 gliomas and 2 patients with mesial temporal sclerosis and medically intractable epilepsy--lateralization of language) and three healthy subjects were studied on a 1.5 T system (Signa GE) using a blood oxygen level-dependent (BOLD)--sensitive multi-slice EPI technique. Different paradigms for localization of the motor (hand/foot) and verbal fluency sensorimotor cortex were tested and selected for each pathology. In healthy subjects motor activation elicited BOLD signal changes in the sensorimotor cortex, permitting identification of primary motor and sensory cortical areas and focal activation of different cortical areas by a verbal fluency task. Twelve motor studies were performed and in 6 RMF results demonstrated the localization of motor hand areas near the lesion, and in nine studies of verbal fluency 6 activation were adjacent to the lesion. The studies were performed prior to neurosurgical procedures, contributed to therapeutical decisions and proved to be a valuable non invasive method of cortical mapping for preoperative planning.