• Mohamad Bakhaidar, Rakan Bokhari, Jeffery Alan Hall, and Farhan A Mirza.
• Departments of Neurology and Neurosurgery, Montreal Neurological Hospital and Institute, McGill University, Montreal, Quebec, Canada; Neurosurgical Simulation and Artificial Intelligence Learning Centre, Department of Neurology and Neurosurgery, Montreal Neurological Hospital and Institute, McGill University, Montreal, Quebec, Canada; Department of Surgery, Division of Neurosurgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia. Electronic address: Mohamad.bakhaidar@mail.mcgill.ca.
• World Neurosurg. 2022 Nov 1; 167: e165e171e165-e171.

BackgroundAnatomic studies have suggested that the central insular sulcus (CIS) runs in line with the Rolandic sulcus (RS). The radiographic relationship between the RS and CIS has not been systematically studied. This study aims to evaluate the applicability of using the CIS as a radiologic landmark to identify the RS.MethodsWe retrospectively reviewed 100 consecutive normal magnetic resonance imaging (MRI) scans (200 hemispheres) performed at a single institution. MRI scans with any intracranial pathology or finding were excluded. Sagittal and axial fluid-attenuated inversion recovery sequences were used in this study. Two evaluators independently evaluated the relationship of the CIS and RS in all MRI scans. A predefined 3-step method was then used to identify the CIS, RS, and hand motor area in sagittal and axial images.ResultsThe CIS was found to be correlated with the RS in 191 hemispheres (95.5%). In the remaining 9 hemispheres, the postcentral sulcus represented the most correlated sulcus with the CIS (7 hemispheres). The interrater agreement was 0.673 (P < 0.05), indicating a substantial agreement. The hand motor area was identified in the same section as the CIS in 175 hemispheres (87.5%).ConclusionsThe CIS is a highly reliable radiographic landmark for the identification of the RS. The hand motor area can also be identified reliably using this method.Copyright © 2022 Elsevier Inc. All rights reserved.

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