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Figure 1: Left temporal lobe metastatic adenocarcinoma in 77-year-old man. Transverse functional MR images derived from series of T2*-weighted echo-planar MR images (2000/40, 24 x 24-cm field of view, 64 x 64 matrix, 5-mm section thickness, no intersection gap) are displayed as thresholded activation maps overlaid in red and yellow on a set of coplanar transverse T2-weighted fast spin-echo MR images (3000/84, 24 x 24-cm field of view, 256 x 192 matrix, 5-mm section thickness, no intersection gap, echo train length of eight). Surgery was not initially planned because of presumed involvement of receptive speech area. Left inferior frontal gyral activation (yellow arrows) is consistent with dominant expressive speech area and is separate from but abuts anterior margin of superior aspect of T2-weighted signal intensity abnormality in left temporal lobe and superior aspect of small left frontal T2 component. Left middle temporal gyrus activation (green arrows) is consistent with dominant receptive speech area and is lateral to midposterior portion of T2 hyperintense component. Craniotomy with mapping was performed, and resection was extended. No postoperative neurologic deficits were documented.
