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1.
Artigo em Russo | MEDLINE | ID: mdl-35942834

RESUMO

OBJECTIVE: To develop a system for preoperative prediction of individual activations of motor and speech areas in patients with brain gliomas using resting state fMRI (rsfMRI), task-based fMRI (tb-fMRI), direct cortical stimulation and machine learning methods. MATERIAL AND METHODS: Thirty-three patients with gliomas (19 females and 14 males aged 19 - 540) underwent DCS-assisted resection of tumor (19 ones with lesion of motor zones and 14 patients with lesions of speech areas). Awake craniotomy was performed in 14 cases. Preoperative mapping was performed according to special MRI protocol (T1, tb-fMRI, rs-fMRI).Machine learning system was built on open source data from The Human Connectome Project. MR data of 200 healthy subjects from this database were used for system pre-training. Further, this system was trained on the data of our patients with gliomas. RESULTS: In DCS, we obtained 332 stimulations including 173 with positive response. According to comparison of functional activations between rs-fMRI and tb-fMRI, there were more positive DCS responses predicted by rs-fMRI (132 vs 112). Non-response stimulation sites (negative) prevailed in tb-fMRI activations (69 vs 44). CONCLUSION: The developed method with machine learning based on resting state fMRI showed greater sensitivity compared to classical task-based fMRI after verification with DCS: 0.72 versus 0.66 (p<0.05) for identifying the speech zones and 0.79 versus 0.62 (p<0.05) for motor areas.


Assuntos
Neoplasias Encefálicas , Glioma , Mapeamento Encefálico/métodos , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/cirurgia , Feminino , Glioma/diagnóstico por imagem , Glioma/cirurgia , Humanos , Aprendizado de Máquina , Imageamento por Ressonância Magnética/métodos , Masculino
2.
Artigo em Russo | MEDLINE | ID: mdl-35942835

RESUMO

OBJECTIVE: To analyze and compare the results of cerebral cortex mapping with task-based (tb-fMRI) and resting-state functional MRI in patients with glioma of eloquent cortical areas. MATERIAL AND METHODS: There were 55 patients (24 men and 31 women aged 24 - 74 years, median 39) with glial tumors. In 26 patients, the tumor was located in motor areas. Twenty-nine patients had lesions of Broca and Wernicke's areas. All patients underwent preoperative tb-fMRI and rs-fMRI. Then, resection of tumor was carried out in all cases. RESULTS: Comparison of fMRI and rs-fMRI activation maps was assessed by calculating the Dice coefficient for inclusive speech and motor cortex masks and exclusive masks without brainstem, cerebellum, subcortical nuclei. Inclusive Dice coefficient for motor cortex ranged from 0.11 to 0.50, for speech cortex - from 0.006 to 0.240 (p<0.05). In case of exclusive masks, this value ranged from 0.15 to 0.55 for motor cortex and from 0.004 to 0.205 for speech cortex (p<0.05). CONCLUSION: When comparing the results of cortical mapping in patients with glial tumors, the use of hemispheric exclusive and inclusive masks did not significantly increase activation maps matching. Probably, low degree of correspondence was associated with different genesis of activations, as well as with high variability of speech cortex.


Assuntos
Neoplasias Encefálicas , Glioma , Córtex Motor , Mapeamento Encefálico/métodos , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/cirurgia , Feminino , Glioma/diagnóstico por imagem , Glioma/cirurgia , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Córtex Motor/diagnóstico por imagem , Córtex Motor/cirurgia
3.
Artigo em Russo | MEDLINE | ID: mdl-32759923

RESUMO

Maximum resection and preservation of neurological function are main principles in surgery of brain tumors, especially glial neoplasms with diffuse growth. Therefore, exact localizing of eloquent brain areas is an important component in surgical planning ensuring optimal resection with minimal postoperative neurological deficit. Functional MRI is used to localize eloquent brain areas adjacent to the tumor. This paper is an initial stage in analysis of resting-state fMRI in assessment of functional changes of neuronal activity caused by brain gliomas of different localization. We report two patients with glial tumors localized within the precentral gyrus of the left hemisphere and near speech area. Considering data of task-based and resting-state fMRI, as well as direct cortical stimulation, we propose a methodology for assessing the overlap of activations obtained by these methods.


Assuntos
Neoplasias Encefálicas/cirurgia , Glioma/cirurgia , Mapeamento Encefálico , Lobo Frontal , Humanos , Imageamento por Ressonância Magnética
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