Functional MR activation correlated with intraoperative cortical mapping

PURPOSE: To evaluate the spatial specificity of functional MR imaging by comparing it with intraoperative electrocortical mapping. METHODS: Functional MR imaging was performed in 28 patients before awake craniotomy and intraoperative electrocortical mapping. Activation was mapped for finger movement, lip movement, tongue movement, word generation, and counting paradigms. During surgery, finger movement, lip movement, tongue movement, counting, and/or speaking were mapped. The functional images and the photographic recordings of the brain functions mapped during surgery were converted to bit maps and coregistered by a computer program. The distance between the intraoperatively mapped function site and the MR activation site for a comparable function was measured. RESULTS: Forty-six functions were recorded on MR images and intraoperative maps. In 100% of correlations, the intraoperative site and the MR activation site were within 20 mm; in 87% of correlations they were within 10 mm. For each paradigm, 67% or more of the intraoperative stimulation maps correlated within 10 mm of the MR activation site. CONCLUSIONS: For the tasks used in this study, the activation site on functional MR images correlated well with the site at which intraoperative stimulation identified function.