Multimodal brain tumour diagnostics for the individual planning of neuro-surgical interventions in the area of eloquent brain areas – diagnostic possibilities by means of modern MRI devices (1,5 T)

Abstract

Neurosurgeon's broad interventions in the central region or in the language area are always to be made worse with a raised risk linkedly the already existing clinical symptomatology with suitable radicality or to reach an insufficient radicality by too careful operation which leads to a bad long time result in particular with brain tumours. Today by the advancement of the MRI devices are available to us for the routine procedure which make possible post surgical findings deteriorations calculable in particular in the OP planning. Beside the morphological information the surgeon can fall back increasingly also on functional information and get this directly in the OP microscope visualised. Today the proton spectroscopy is already presurgical in the position to determine non-invasive an intrakranielle lesion with regard to the diagnosis closer. Furthermore succeeds it with tumours belonging to brain in carrying out a sure classification which determines then the other surgical action with. The visualisation of the pyramidal tract by means of diffusion wihgtet imaging (DWI) and next fiber tracking matters in particular to the OP of tumours in the central region. The planning of the surgical access, as well as the individual OP realisation lead to a better post surgical outcome of the patients with the purpose the existing symptomatology not to make worse. The application fMRI to the visualisation of the language area (BROCA and WERNICKE) led on the one hand to a verse improvement to post surgical outcome and, on the other hand, to a conformist radicality with improvement of the whole result. Besides, an enough good result can be reached under use easier of technical aids and application of a description or word generation paradigm. The determining position of BROCA and WERNICKE succeeded with it up to now always.