ldtЛучевая диагностика и терапияDiagnostic radiology and radiotherapy2079-5343Baltic Medical Education Center10.22328/2079-5343-2020-11-3-25-37ldt-544Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL RESEARCHBOLD ФМРТ КАРТИРОВАНИЕ ФУНКЦИОНАЛЬНО ЗНАЧИМЫХ ЗОН КОРЫ У ПАЦИЕНТОВ С ОПУХОЛЯМИ ГОЛОВНОГО МОЗГА С ПРИМЕНЕНИЕМ ДОПОЛНИТЕЛЬНЫХ ФИЗИОЛОГИЧЕСКИХ ПАРАМЕТРОВBOLD FMRI MAPPING OF ELOQUENT CORTICAL AREAS IN PATIENTS WITH BRAIN TUMOR USING INDEPENDENT PHYSIOLOGICAL PARAMETERShttps://orcid.org/0000-0002-8924-7346БаталовА. И.BatalovA. I.

кандидат медицинских наук, младший научный сотрудник отделения рентгеновских и радиоизотопных методов диагностики

125047, Москва, ул. 4-я Тверская-Ямская, д. 16

abatalov@nsi.ruhttps://orcid.org/0000-0002-0516-3613ЗахароваН. Е.ZakharovaN. E.

доктор медицинских наук, профессор РАН, ведущий научный сотрудник отделения рентгеновских и радиоизотопных методов диагностики

125047, Москва, ул. 4-я Тверская-Ямская, д. 16

nzakharova@nsi.ruhttps://orcid.org/0000-0002-4480-0275ПронинИ. Н.ProninI. N.

доктор медицинских наук, профессор, академик РАН, заместитель директора по науке, заведующий отделением рентгеновских и радиоизотопных методов диагностики

125047, Москва, ул. 4-я Тверская-Ямская, д. 16 

pronin@nsi.ruhttps://orcid.org/0000-0002-4803-6948ПогосбекянЭ. Л.PogosbekyanE. L.

медицинский физик отделения рентгеновских и радиоизотопных методов диагностики

125047, Москва, ул. 4-я Тверская-Ямская, д. 16

epogosbekyan@nsi.ruhttps://orcid.org/0000-0002-3240-5585ФадееваЛ. М.FadeevaL. M.

ведущий инженер отделения рентгеновских и радиоизотопных методов диагностики

125047, Москва, ул. 4-я Тверская-Ямская, д. 16

lmf@nsi.ruhttps://orcid.org/0000-0002-6480-3270ГоряйновС. А.GoryaynovS. A.

нейрохирург, кандидат медицинских наук, старший научный сотрудник

125047, Москва, ул. 4-я Тверская-Ямская, д. 16

Sgoraynov@nsi.ruhttps://orcid.org/0000-0002-3019-5203КосырьковаА. В.KosyrkovaA. V.

врач-нейрохирург, аспирант

125047, Москва, ул. 4-я Тверская-Ямская, д. 16

Akosyrkova@nsi.ruhttps://orcid.org/0000-0001-8343-3511ПотаповА. А.PotapovA. A.

доктор медицинских наук, профессор, академик РАН, научный руководитель

125047, Москва, ул. 4-я Тверская-Ямская, д. 16 

apotapov@nsi.ruНациональный медицинский исследовательский центр нейрохирургии имени академика Н. Н. БурденкоРоссияBurdenko Neurosurgery CenterRussian Federation2020080920201132537Copyright © Баталов А.И., Захарова Н.Е., Пронин И.Н., Погосбекян Э.Л., Фадеева Л.М., Горяйнов С.А., Косырькова А.В., Потапов А.А., 20202020Баталов А.И., Захарова Н.Е., Пронин И.Н., Погосбекян Э.Л., Фадеева Л.М., Горяйнов С.А., Косырькова А.В., Потапов А.А.Batalov A.I., Zakharova N.E., Pronin I.N., Pogosbekyan E.L., Fadeeva L.M., Goryaynov S.A., Kosyrkova A.V., Potapov A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://radiag.bmoc-spb.ru/jour/article/view/544Введение

Введение. Предоперационные BOLD фМРТ часто показывают понижение BOLD-ответа, вызванное патологической вазореактивностью вследствие нейроваскулярного разобщения в перифокальных опухолям зонах головного мозга.

Цель исследования

Цель исследования: разработать алгоритм получения карт BOLD-активации, учитывающий измененную гемодинамику у пациентов с внутримозговыми и внемозговыми опухолями, при сопоставлении карт BOLD-ответа на моторные и речевые задания с/без включения задачи задержки дыхания.

Материалы и методы

Материалы и методы. В исследование включено 23 пациента с опухолями головного мозга, расположенными вблизи функционально значимых зон коры. Всем пациентам осуществлялось фМРТ-картирование речевых и/или двигательных зон коры головного мозга в зависимости от локализации опухоли, а также проводился тест с задержкой дыхания, дизайн которого совпадал с моторными и речевыми блоковыми парадигмами.

Результаты

Результаты. Полученная зависимость между моторными или речевыми заданиями и ответом на задержку дыхания была включена в постобработку данных фМРТ с использованием когерентного анализа. Карты, построенные этим методом, показали клинически значимые области активации, прилегающие к опухолям головного мозга, не выявлявшиеся с помощью стандартного метода анализа.

Заключение

Заключение. Результаты фМРТ-картирования можно частично улучшить включением данных измерения вазореактивности в стандартный анализ.

Introduction

Introduction. Preoperative fMRI often shows a reduced BOLD response in the areas located perifocal to brain tumors caused by pathological vasoreactivity as a result of neurovascular uncoupling.

The aim of this study was an accurate identification of the eloquent cortical areas near brain tumors by measuring vasoreactivity using the breath holding test.

Material and methods

Material and methods. 23 patients with brain tumors located near eloquent cortical areas underwent fMRI mapping of the language and / or motor cortical areas depending on the location of the tumor. Breath hold test was  also included, the design of which coincided with motor and language block paradigms.

Results

Results. A statistical dependency between motor, speech tasks and breath-hold BOLD-response was included into the BOLD analysis using coherence. fMRI activation maps generated by this method showed activation in the eloquent areas adjacent to brain tumors which were not detected by the standard analysis. This study shows that neurovascular uncoupling affects the accuracy of BOLD fMRI in brain tumors.

Conclusion

Conclusion. The results of fMRI mapping can be partially improved by the incorporating vasoreactivity measurements into a standard analysis.

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