radiologyРадиология — практикаRadiology - Practice2713-0118Центральный научно-исследовательский институт лучевой диагностикиradiology-115Research ArticleКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯ И КРАТКИЕ СООБЩЕНИЯCLINICAL OBSERVATIONS AND BRIEF REPORTSФункциональная магнитно-резонансная томография головного мозга для локализации речевой коры в предоперационном планировании. Разбор клинических случаевHuman Brain Functional Magnetic Resonance Imaging for Language Cortex Localization in Presurgical Brain Mapping. Case reporthttps://orcid.org/0000-0001-9313-6350СмирновА. С.SmirnovA. S.alex.s.smirnof@gmail.comhttps://orcid.org/0000-0002-5670-2891ШараевМ. Г.SharaevM. G.m.sharaev@skoltech.ruhttps://orcid.org/0000-0001-6760-9505Мельникова-ПицхелауриТ. В.Mel'nikova-PitskhelauriT. V.MelPitz@nsi.ruhttps://orcid.org/0000-0002-4803-6948ПогосбекянЭ. Л.PogosbekyanE. L.epogosbekyan@nsi.ruhttps://orcid.org/0000-0002-2523-3009ЖуковВ. Ю.ZhukovV. Ju.vjukov@nsi.ruhttps://orcid.org/0000-0002-9451-3565БуклинаС. Б.BuklinaS. B.sbuklina@nsi.ruhttps://orcid.org/0000-0003-3595-2696ОгурцоваА. А.OgurtsovaA. A.aogurtsova@nsi.ruhttps://orcid.org/0000-0001-8424-0690БурнаевА. Е.BurnaevA. E.e.burnaev@skoltech.ruhttps://orcid.org/0000-0002-5250-1849БернштейнА. В.BernstainA. V.a.bernstein@skoltech.ruhttps://orcid.org/0000-0003-0374-7970ПицхелауриД. И.PitskhelauriD. I.dav@nsi.ruhttps://orcid.org/0000-0002-0487-1183КорниенкоВ. Н.KornienkoV. N.kornienko@nsi.ruhttps://orcid.org/0000-0002-4480-0275ПронинИ. Н.ProninI. N.pronin@nsi.ruФГАУ «НМИЦ нейрохирургии им. акад. Н. Н. Бурденко» Минздрава РоссииРоссияFederal State Autonomous Institution «N.N. Burdenko National Medical Research Center of Neurosurgery», Ministry of Healthcare of RussiaRussian FederationСколковский институт науки и технологийРоссияSkolkovo Institute of Science and TechnologyRussian Federation202028082020046878Copyright © Смирнов А.С., Шараев М.Г., Мельникова-Пицхелаури Т.В., Погосбекян Э.Л., Жуков В.Ю., Буклина С.Б., Огурцова А.А., Бурнаев А.Е., Бернштейн А.В., Пицхелаури Д.И., Корниенко В.Н., Пронин И.Н., 20202020Смирнов А.С., Шараев М.Г., Мельникова-Пицхелаури Т.В., Погосбекян Э.Л., Жуков В.Ю., Буклина С.Б., Огурцова А.А., Бурнаев А.Е., Бернштейн А.В., Пицхелаури Д.И., Корниенко В.Н., Пронин И.Н.Smirnov A.S., Sharaev M.G., Mel'nikova-Pitskhelauri T.V., Pogosbekyan E.L., Zhukov V.J., Buklina S.B., Ogurtsova A.A., Burnaev A.E., Bernstain A.V., Pitskhelauri D.I., Kornienko V.N., Pronin I.N.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.radp.ru/jour/article/view/115

В нейрохирургической практике в качестве основного метода неинвазивного предоперационного планирования при локализации опухоли вблизи функционально значимых зон коры используется стимулзависимая функциональная МРТ (фМРТс) с двигательными или речевыми парадигмами. Этот метод способен предоставить важную информацию об индивидуальных особенностях локализации значимых зон коры головного мозга пациента. Однако результат функционального МР-исследования во многом зависит от способности пациента четко выполнять типовые инструкции, которые могут нарушаться или даже не выполняться пациентами с опухолями головного мозга. В таких случаях возможно использование метода фМРТ в состоянии покоя (фМРТп, resting-state fMRI). В данной работе, которая является частью проекта по изучению функциональных изменений нейрональной активности мозга, вызванных глиомами, мы приводим два наблюдения пациентов с опухолями, локализующимися в левом полушарии головного мозга в лобной и височной областях, вблизи зон Брока и Вернике. На основе сравнения результатов методов фМРТс, фМРТп и данных прямой кортикальной стимуляции, обсуждается методика определения точности совпадения активаций, полученных тремя методами.

In neurosurgical practice of neurosurgery, a task-based functional magnetic resonance imaging (tb-fMRI) with motor and speech paradigms is a common method in preoperative planning lesion location around eloquent areas of the brain. This method can improve the surgical strategy with relevant information obtained non-invasively. But in majority of cases the results of tb-fMRI depend on the patient’s ability to follow instructions during study, which can be impaired due to brain tumor. When tasks cannot be performed by patient, the resting-state fMRI method (rs-fMRI) is more preferable. In this work, that is a part of the scientific project in assessment of neuronal activity in cases with brain gliomas of various localization, we present two cases of patients with glial tumors localized in the left hemisphere of the brain: frontal and temporal lobes with close proximity to Broca and Wernike areas. Based on a comparison of the results of tb-fMRT, rs-fMRT as well as direct cortical stimulation data, we propose a method for estimation the accuracy of coincidence in cortical activations obtained by three methods.

МРТ головного мозгафункциональная МРТфМРТ покояпредоперационное планированиекартирование мозгаглиальная опухольфункционально значимые зоныBrain Magnetic Resonance ImagingFunctional Magnetic Resonance ImagingResting-State Functional Magnetic Resonance ImagingPresurgical PlanningBrain MappingGliomaEloquent AreaReferencesDe Benedictis A., Moritz-Gasser S., Duffau H. Awake mapping optimizes the extent of resection for low-grade gliomas in eloquent areas. Neurosurg. 2010. V. 66. No. 6. P. 1074-1084.De Benedictis A., Moritz-Gasser S., Duffau H. Awake mapping optimizes the extent of resection for low-grade gliomas in eloquent areas. Neurosurg. 2010. V. 66. No. 6. P. 1074-1084.Benjamin C. F., Walshaw P. D., Hale K. et al. Presurgical language fMRI: Mapping of six critical regions. Human Brain Mapping. 2017. V. 38. No. 8. P. 4239-4255.Benjamin C. F., Walshaw P. D., Hale K. et al. Presurgical language fMRI: Mapping of six critical regions. Human Brain Mapping. 2017. V. 38. No. 8. P. 4239-4255.Branco P., Seixas D., Castro S. L. Resting-state functional magnetic resonance imaging for language preoperative planning. Frontiers in Human Neuroscience. 2016. V. 10.Branco P., Seixas D., Castro S. L. Resting-state functional magnetic resonance imaging for language preoperative planning. Frontiers in Human Neuroscience. 2016. V. 10.Branco P., Seixas D., Castro S. L. Temporal reliability of ultra-high field resting-state MRI for single-subject sensorimotor and language mapping. NeuroImage. 2018. V. 168. P. 499-508.Branco P., Seixas D., Castro S. L. Temporal reliability of ultra-high field resting-state MRI for single-subject sensorimotor and language mapping. NeuroImage. 2018. V. 168. P. 499-508.Forster M.-T., Hattingen E., Senft C. et al. Navigated transcranial magnetic stimulation and functional magnetic resonance imaging: advanced adjuncts in preoperative planning for central region tumors. Neurosurg. 2011. V. 68. No. 5. P. 1317-1325.Forster M.-T., Hattingen E., Senft C. et al. Navigated transcranial magnetic stimulation and functional magnetic resonance imaging: advanced adjuncts in preoperative planning for central region tumors. Neurosurg. 2011. V. 68. No. 5. P. 1317-1325.Giussani C., Roux F.-E., Ojemann J. et al. Is preoperative functional magnetic resonance imaging reliable for language areas mapping in brain tumor surgery? Review of language functional magnetic resonance imaging and direct cortical stimulation correlation studies. Neurosurg. 2010. V. 66. No. 1. P. 113-120.Giussani C., Roux F.-E., Ojemann J. et al. Is preoperative functional magnetic resonance imaging reliable for language areas mapping in brain tumor surgery? Review of language functional magnetic resonance imaging and direct cortical stimulation correlation studies. Neurosurg. 2010. V. 66. No. 1. P. 113-120.Hart M. G., Price S. J., Suckling J. Connectome analysis for pre-operative brain mapping in neurosurgery. British J. of Neurosurg. 2016. V. 30. No. 5. P. 506-517.Hart M. G., Price S. J., Suckling J. Connectome analysis for pre-operative brain mapping in neurosurgery. British J. of Neurosurg. 2016. V. 30. No. 5. P. 506-517.Junck L., Hervey-Jumper S. L., Sagher O. Resection of gliomas around language areas: Can fMRI contribute? Neurol. 2015. V. 84. No. 6. P. 550-551.Junck L., Hervey-Jumper S. L., Sagher O. Resection of gliomas around language areas: Can fMRI contribute? Neurol. 2015. V. 84. No. 6. P. 550-551.Kuchcinski G., Mellerio C., Pallud J. et al. Three-tesla functional MR language mapping: Comparison with direct cortical stimulation in gliomas. Neurol. 2015. V. 84. No. 6. P. 560-568.Kuchcinski G., Mellerio C., Pallud J. et al. Three-tesla functional MR language mapping: Comparison with direct cortical stimulation in gliomas. Neurol. 2015. V. 84. No. 6. P. 560-568.Lu J., Zhang H., Hameed N. U. F. et al. An automated method for identifying an independent component analysis-based language-related resting-state network in brain tumor subjects for surgical planning. Scientific Reports. 2017. V. 7. No. 1. P. 13769.Lu J., Zhang H., Hameed N. U. F. et al. An automated method for identifying an independent component analysis-based language-related resting-state network in brain tumor subjects for surgical planning. Scientific Reports. 2017. V. 7. No. 1. P. 13769.Meier M. P., Ilmberger J., Fesl G. et al. Validation of functional motor and language MRI with direct cortical stimulation. Acta Neurochirurgica. 2013. V. 155. No. 4. P. 675-683.Meier M. P., Ilmberger J., Fesl G. et al. Validation of functional motor and language MRI with direct cortical stimulation. Acta Neurochirurgica. 2013. V. 155. No. 4. P. 675-683.Ojemann G., Mateer C. Human language cortex: localization of memory, syntax, and sequential motor-phoneme identification systems. Science. 1979. V. 205. No. 4413. P. 1401-1403.Ojemann G., Mateer C. Human language cortex: localization of memory, syntax, and sequential motor-phoneme identification systems. Science. 1979. V. 205. No. 4413. P. 1401-1403.Rosazza C., Minati L. Resting-state brain networks: literature review and clinical applications. Neurological Sci. 2011. V. 32. No. 5. P. 773-785.Rosazza C., Minati L. Resting-state brain networks: literature review and clinical applications. Neurological Sci. 2011. V. 32. No. 5. P. 773-785.Roux F.-E., Boulanouar K., Lotterie J.-A. et al. Language functional magnetic resonance imaging in preoperative assessment of language areas: correlation with direct cortical stimulation. Neurosurg. 2003. V. 52. No. 6. P. 1335-1347.Roux F.-E., Boulanouar K., Lotterie J.-A. et al. Language functional magnetic resonance imaging in preoperative assessment of language areas: correlation with direct cortical stimulation. Neurosurg. 2003. V. 52. No. 6. P. 1335-1347.Sair H. I., Agarwal S., Pillai J. J. Application of resting state functional mr imaging to presurgical mapping. Neuroimaging Clinics of North America. 2017. V. 27. No. 4. P. 635-644.Sair H. I., Agarwal S., Pillai J. J. Application of resting state functional mr imaging to presurgical mapping. Neuroimaging Clinics of North America. 2017. V. 27. No. 4. P. 635-644.Sharaev M., Smirnov A., Melnikova-Pitskhelauri T. et al. Functional brain areas mapping in patients with glioma based on resting-state fmri data decomposition. IEEE. 2018. P. 292-298.Sharaev M., Smirnov A., Melnikova-Pitskhelauri T. et al. Functional brain areas mapping in patients with glioma based on resting-state fmri data decomposition. IEEE. 2018. P. 292-298.Smirnov A. S., Sharaev M. G., Melnikova-Pitskhelauri T. V. et al. Resting state fMRI in pre-surgical brain mapping. Literature review. Medical Visualization. 2018. No. 5. P. 6-13.Smirnov A. S., Sharaev M. G., Melnikova-Pitskhelauri T. V. et al. Resting state fMRI in pre-surgical brain mapping. Literature review. Medical Visualization. 2018. No. 5. P. 6-13.

The authors declare that there are no conflicts of interest present.