Abstract
BACKGROUND: Anatomic studies have suggested that the central insular sulcus (CIS) runs in line with the Rolandic sulcus (RS). The radiographic relationship be-tween 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. METHODS: We retrospectively reviewed 100 consecu-tive 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 se-quences were used in this study. Two evaluators inde-pendently 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. RESULTS: The CIS was found to be correlated with the RS in 191 hemispheres (95.5%). In the remaining 9 hemi-spheres, the postcentral sulcus represented the most correlated sulcus with the CIS (7 hemispheres). The inter -rater agreement was 0.673 (P < 0.05), indicating a sub-stantial agreement. The hand motor area was identified in the same section as the CIS in 175 hemispheres (87.5%). CONCLUSIONS: The CIS is a highly reliable radio-graphic landmark for the identification of the RS. The hand motor area can also be identified reliably using this method.