Main Article Content
Background: Correct identification of the central sulcus and adjacent gyri is essential for localizing tumors and planning effective surgery. With brain lesions central sulcus and surrounding sensory and motor eloquent areas may be obliterated. Central sulcus is the sulcus anterior to the pars marginalis on axial images.
Purpose: To evaluate the presence of marginal sulcus in axial cuts brain MRI among Sudanese population and to use it as land mark for central sulcus localization.
Methodology: The study included 100 normal MRI of both sex of adult age group. The pars marginalis and pars bracket sign was assessed and the direct relation to the central sulcus was observed.
Results: This study included 100 participants, (55 males and 45 females). The mean age of patients was 32.2 (+/- 7.4) years (range, 18–73 years). Pars marginalis and bracket sign were observed in all cases. In all cases, the central sulcus was observed to be anterior to the pars bracket. In 97 cases (53 males and 44 females), the central sulcus enters into the bracket, while in the remaining 3 cases it did not reach the pars bracket. No significant difference was observed between males and females.
Conclusion: Pars bracket sign was proved to be a reliable and quite effective signs to localize the central sulcus.
Craig Hacking, Frank Gaillard, et al. Marginal sulcus. Radiopedia.
Yousry TA, Schmid UD, Alkadhi H, Schmidt D, Peraud A, Buettner A, et al. Localization of the motor hand area to a knob on the precentral gyrus. A new landmark. Brain. 1997;120:141–57.
Campero A, Ajler P, Martins C, Emmerich J. Usefulness of the contralateral Omega sign for the topographic location of lesions in and around the central sulcus. Surgical Neurology International. 2011;2:164.
Clarisse J, Soto Ares G, Pertuzon B, Ayachi M, Francke JP. Identification of the central sulcus using the scanner and MRI. Journal of Neuroradiology. 1997;24(3): 187-204.
Guilherme Carvalhal Ribas. The cerebral sulci and gyri. JNS; 2010.
Kim EY, Kim DH, Chang JH, Yoo E, Lee JW, Park HJ. Triple-layer appearance of Brodmann area 4 at thin-section double inversion-recovery MR imaging. Radiology. 2009;250(2):515-22.
Willemse RB, Pouwels PJ, Barkhof F, Vandertop WP. Localisation of the central sulcus region in glioma patients with three-dimensional fluid-attenuated inversion recovery and volume rendering: Comparison with functional and conventional magnetic resonance. British Journal of Neurosurgery. 2011;25(2):210-7.
Karaarslan E, Arslan A. ROI measurement of the signal intensity of precentral cortex in the normal brain. European Journal of Radiology. 2004;52(3):221-3.
Kaneko OF, Fischbein NJ, Rosenberg J, Wintermark M, Zeineh MM. The "White Gray Sign" identifies the central sulcus on 3T high-resolution T1-weighted images. AJNR. American Journal of Neuro-radiology. 2017;38(2):276-280.
Naidich TP, Brightbill TC. The pars marginalis, II: A "bracket" sign for the central sulcus in axial plane CT and MRI. Int J. Neuroradiol. 1996;2:3-19.
Carrasco E, Domitrovic L, Ypa P, Gandarillas Baldelomar B, Fuentes F, Arcos A. Useful signs for identification of the central sulcus in MRI. International Nuclear Information System (INIS). 2011;01-01.