Useful Seven Signs for Fast Identification of the Central Sulcus in Magnetic Resonance Imaging

Introduction: Luigi Rolando described the central sulcus (CS) in 1829. Identifying the central sulcus on MRI is important for the anatomical localization of the motor area, especially during surgical planning.

Methods: Magnetic resonance imaging (MRI) of 60 adult patients (18 to 83 years old), of both sexes (34 females and 26 males) with normal brains, in rostral axial slices weighted in T1 and T2 sequences, performed in a 1.5-tesla resonator, was used.
The following signs were looked at:
1 The junction of the superior frontal sulcus with the precentral sulcus.
2 The sign of the inverted omega.
3 The imprint of the marginal branch of the cingulum sulcus on the convexity ("pars bracket").
4 The postcentral sulcus that bifurcates in its superior portion.
5 The postcentral gyrus is finer than the precentral gyrus.
6 The junction of the intraparietal sulcus with the postcentral sulcus.
7 The central sulcus reaches the midline.
The frequency and percentage of each of the described signs were determined.

Results: 60 MRIs were observed, 34 were female cases, and 26 were male. The average age was 45.55 years. The superior frontal sulcus is united with the precentral sulcus in 95%. The inverted omega sign is evident in 96.66%. The pars bracket sign is present in 95%. The postcentral sulcus is bifid in 65%. The postcentral gyrus is narrower than the precentral gyrus by 98.33%. The intraparietal sulcus intercepts with the postcentral sulcus in 88.33%. The central sulcus reaches the midline at 86.66%.

Conclusion : The identification of the central sulcus and motor area on MRI is important during surgical planning. It is useful to know the lesion's functional implications generated and infer the surgical sequelae. The seven signs described have a high frequency of presentation, being found on average in 89.28% of the MRIs observed.