アベ カヨコ   ABE Kayoko
  阿部 香代子
   所属   医学部 医学科(東京女子医科大学病院)
   職種   講師
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Rolesof the Wada Test and Functional Magnetic Resonance Imaging in Identifying the Language-dominant Hemisphere among Patients with Gliomas Located near Speech Areas
掲載誌名 正式名:Neurologia medico-chirurgica
略  称:Neurol Med Chir (Tokyo)
ISSNコード:04708105
掲載区分国外
巻・号・頁 57(1),pp.28-34
著者・共著者 ISHIKAWA Tatsuya†, MURAGAKI Yoshihiro, MARUYAMA Takashi, ABE Kayoko, KAWAMATA Takakazu
発行年月 2017/01
概要 This study examined the accuracy of functional magnetic resonance imaging (fMRI) in identifying the language-dominant hemisphere and the situations in which the Wada test can be skipped among patients with gliomas located near speech areas. We examined 74 patients [48 men (64.9%); mean +/- standard deviation age of 42.7 +/- 13.6 years (range: 13 to 70 years); 71 right-handed, 2 left-handed, and 1 ambidextrous]with gliomas located near speech areas. All patients underwent the Wada test and fMRI, and 34 patients underwent awake surgery. The"last-and-first"task was administered during fMRI. The Wada test was successful in determining the language-dominant hemisphere in 73 patients (98.6%): left hemisphere in 68 patients (91.9%), right hemisphere in 4 patients (5.4%), and bilateral in 1 patient (1.4%). The dominant hemisphere for right-handed patients (n = 71) was the left hemisphere in 67 patients (94.3%), right hemisphere in 3 patients (4.2%), and undetectable in 1 patient (1.4%). The fMRI was successful in determining the language-dominant hemisphere in 53 patients (71.6%). The results of the Wada test and fMRI were inconsistent in 5 patients (8.6%), of which 3 (5.2%) exhibited dominance in opposite hemispheres. Furthermore, 2 of these 3 cases (2.7%) were contralateral false positive cases, whereby fMRI identified the right-hemisphere as language dominant for right-handed individuals with tumors in the left hemisphere. Based on these findings, we concluded that the Wada test can be skipped if language dominancy can be detected by fMRI.
DOI 10.2176/nmc.oa.2016-0042
文献番号 27980284