Abstract

Objective: To study the use of reconstructed3D brain surface imageto identify the precentralgyrus and its detail functionaldistribution. Method: There are a total of 12refractory epilepsy caseswhich need intracranial electrode implantation according to a preoperative assessment. In these patients, magnetic resonance imaging (MRI) and functional MRI (fMRI) wereconducted pre-operation, and a cranial computed tomography (CT) scan was performed after electrode implantation. BrainVoyager software was used for 3D reconstruction of the brain surface by using MRI data, which was integrated with the subdural electrode CT. Based on the characteristics of the shape of the precentralgyrus, the precentralgyrus was marked in the reconstructed brain surface image, and the precentralgyrus and adjasentgyrus were found and identified in the surgical field by comparingthe typical shape of the exposed gyrus in the reconstructed3D brain surface image with that in theintraoperative photographs. The reliability of the precentralgyrus identified by the presentmethod was verified by electrical cortical stimulation (ECS) and fMRI. Results: All the 12 cases were performed 3D brain surface reconstruction and precentralgyruswas found and marked according to the characteristics of precentralgyrus. There were 101 electrodescovering the precentralgyrus and 73 (72%)of them had motor response to electrical stimulation. In the contrast team, (the area which is 1 cm ahead of the precentralgyrusidentied by the reconstructed3D brain surface), the motor response rate was 13% (17/130) (plt;0.05). During fMRI, 100% of the precentralgyrus and 58% (7/12) of postcentralgyrus was activated during hand movement,with no activation of the areas ahead of precentralgyrus, so there was also significant difference between precentralgyrus and gyrus ahead. Therefore, the precentralgyrus identified by the presentmethod is accurate and reliable. Conclusion: It is simple and feasible to identify the precentralgyrusby using