الفهرس 
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Abstract
fMRI imaging has shown tremendous potential as a noninvasive tool for preoperative planning by combining anatomic definition with physiologic information to demonstrate the spatial relationship between functionally eloquent brain regions and intracranial pathologic features. Functional MR imaging can be used to identify eloquent cortical regions, particularly when these cortical regions are displaced or reorganized secondary to pathologic processes, and can facilitate the assessment of potential neurosurgical risks (Tomczak et al 2000).
In addition to providing information regarding the feasibility of resection, functional MR imaging may provide additional information regarding surgical approach and the selection of patients for invasive functional mapping. The results of numerous studies have shown agreement between functional MR imaging localization of sensory motor function and localization by means of invasive neurosurgical methods. Functional MR imaging has been shown to have high sensitivity (81%–92%) for the mapping of language areas in comparison with intraoperative electrocortical stimulation and generates highly reproducible results for global and regional language lateralization, particularly in patients with epilepsy (Lee et al, 1999).
Thus, the purpose of the study is to prospectively evaluate the effect of preoperative functional MR imaging localization of language and motor areas on therapeutic decision making in patients with potentially resectable brain lesion.
The study is designed to follow the decision-making processes of the referring seizure team before and after functional MR imaging to assess the effect of functional MR imaging findings on the diagnostic thinking and decision making of the referring seizure team. Brain surgery has proved to be an effective treatment for individuals with medically intractable epilepsy, particularly for those patients with a single seizure focus. It is important to map lesions that are located in close proximity to critical areas of the brain because of the proximity of the pathologic condition to functional regions and because reorganization of the brain functions may be transferred to other areas in the ipsilateral or contralateral hemispheres. Surgical resection of such epileptogenic lesions requires knowledge of the location of the brain functions of bordering areas to provide a better outcome, preferably without neurologic deficit (Jack et al, 1994).
In summary, the study demonstrated that functional MR imaging results influence the diagnostic and therapeutic decision making of the seizure team. Functional MR imaging results frequently suggest a change in the location of language dominance, increase the confidence level in the identification of critical brain function areas, alter patient and family counseling, and alter intraoperative mapping and the surgical approach.