Combined Three-Dimensional Anisotropy Contrast Imaging and Magnetoencephalography Guidance to Preserve Visual Function in a Patient with an Occipital Lobe Tumor

Abstract

Objective: Three-dimensional anisotropy contrast (3-DAC) magnetic resonance imaging and magnetoencephalography (MEG) of visually evoked magnetic fields (VEFs) were used to accurately localize the optic radiation and primary visual cortex before surgery for an occipital tumor.

Patient and Methods: A 26-year-old male presented with an occipital lobe tumor located intrinsically underneath the right calcarine fissure. 3-DAC imaging showed that the right optic radiation was located along the superior and lateral surfaces of the lesion. Mapping of the VEFs demonstrated that the primary visual cortex was located superior and lateral to the lesion. The lesion was totally resected via an infero-medial cortical incision using a frameless stereotactic system. Histopathology indicated a pilocytic astrocytoma. No visual deficit was found before or after surgery.

Conclusion: Combined 3-DAC imaging and MEG can provide essential information about the optic radiation and primary visual cortex for planning the surgical treatment of occipital lobe tumors.

Brain neoplasms - visual evoked potential - three-dimensional anisotropy contrast imaging - visual function

References

• 1 Nakada T, Nakayama N, Fujii Y, Kwee I L. Clinical application of three-dimensional anisotropy contrast magnetic resonance axonography. Technical note.  J Neurosurg. 1999;  90 791-795
• 2 Kamada K, Houkin K, Iwasaki Y, Takeuchi F, Kuriki S, Mitsumori K, Sawamura Y. Rapid identification of the primary motor area by using magnetic resonance axonography.  J Neurosurg. 2002;  97 558-567
• 3 Inoue T, Shimizu H, Yoshimoto T, Kabasawa H. Imaging the pyramidal tract in patients with brain tumors.  Clin Neurol Neurosurg. 1999;  101 4-10
• 4 Igarashi H, Katayama Y, Tsuganezawa T, Yamamuro M, Terashi A, Owan C. Three-dimensional anisotropy contrast (3DAC) magnetic resonance imaging of human brain: application to assess Wallerian degeneration.  Intern Med. 1998;  37 662-668
• 5 Sumida M, Arita K, Migita K, Iida K, Kurisu K, Uozumi T. Demonstration of the optic pathway in sellar/juxtasellar tumours with visual disturbance on MR imaging.  Acta Neurochir (Wien). 1998;  140 541-548
• 6 Nakasato N, Yoshimoto T. Somatosensory, auditory, and visual evoked magnetic fields in patients with brain diseases.  J Clin Neurophysiol. 2000;  17 201-211
• 7 Seki K, Nakasato N, Fujita S, Hatanaka K, Kawamura T, Kanno A, Yoshimoto T. Neuromagnetic evidence that the P100 component of pattern reversal visual evoked response originates in the bottom of calcarine fissure.  Electroencephalogr Clin Neurophysiol. 1996;  100 436-442
• 8 Nakasato N, Seki K, Fujita S, Hatanaka K, Kawamura T, Ohtomo S, Kanno A, Ikeda H, Yoshimoto T. Clinical application of visual evoked fields using an MRI-linked whole head MEG system.  Front Med Biol Eng. 1996;  7 275-283
• 9 Hatanaka K, Nakasato N, Nagamatsu K, Iwasaki M, Kanno A, Ikeda H, Yoshimoto T. Modification of the pattern-evoked magnetic fields associated with the location of the lesion along the visual pathways. In: Katila T et al (eds.), Proceedings of the 12th International Conference on Biomagnetism. 2001: 145-149
• 10 Shigeto H, Tobimatsu S, Yamamoto T, Kobayashi T, Kato M. Visual evoked cortical magnetic responses to checkerboard pattern reversal stimulation: a study on the neural generators of N75, P100 and N145.  J Neurol Sci. 1998;  156 86-194
• 11 Hatanaka K, Nakasato N, Seki K, Kanno A, Mizoi K, Yoshimoto T. Striate cortical generators of the N75, P100 and N145 components localized by pattern reversal visual evoked magnetic fields.  Tohoku J Exp Med. 1997;  182 9-14
• 12 Kanno A, Nakasato N, Seki K, Hatanaka K, Mizoi K, Yoshimoto T. Postoperative normalization of prolonged P100 m latency in the visual evoked magnetic field in a patient with occipital meningioma.  No To Shinkei. 1997;  49 373-376 (in Japanese)
• 13 Ahonen A, Hämälainen M, Kajola M, Simola J, Tesche C. 122-channel SQUID instrument for investigating the magnetic signals from the human brain.  Phys Scr. 1993;  49 198-205
• 14 Lin Y Y, Simoes C, Forss N, Hari R. Differential effect of muscle contraction from various body parts on neuromagnetic somatosensory responses.  Neuroimage. 2000;  11 334-340
• 15 Karibe H, Shimizu H, Tominaga T, Koshu K, Yoshimoto T. Diffusion-weighted magnetic resonance imaging in the early evaluation of corticospinal tract injury to predict functional motor outcome in patients with deep intracerebral hemorrhage.  J Neurosurg. 2000;  92 58-63
• 16 Inoue T, Shimizu H, Yoshimoto T, Kabasawa H. Spatial functional distribution in the corticospinal tract at the corona radiata: a three-dimensional anisotropy contrast study.  Neurol Med Chir (Tokyo). 2001;  41 293-299
• 17 Weber A L, Klufas R, Pless M. Imaging evaluation of the optic nerve and visual pathway including cranial nerves affecting the visual pathway.  Neuroimaging Clin N Am. 1996;  6 143-177