脑肿瘤术前规划中功能性MRI的现状。

IF 5.6 Q1 ONCOLOGY
Dhairya A Lakhani, David S Sabsevitz, Kaisorn L Chaichana, Alfredo Quiñones-Hinojosa, Erik H Middlebrooks
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引用次数: 0

摘要

脑肿瘤的手术切除具有挑战性,因为在最大限度地切除肿瘤和保留重要的脑功能之间存在微妙的平衡。功能性MRI(fMRI)提供了广泛分布的大脑区域的无创术前标测,并越来越多地用于术前功能标测。然而,它对生存和功能结果的影响仍然没有很好的证据支持。基于任务的fMRI(tb-fMRI)绘制特定任务期间血氧水平依赖性(BOLD)信号的变化,而静息状态fMRI(rs-fMRI)检查自发的大脑活动。rs功能磁共振成像可能对不能执行任务的患者有用,但其可靠性受到肿瘤引起的变化、数据处理的挑战和噪声的影响。将功能磁共振成像与直接皮层刺激(DCS)进行比较的验证研究显示出不同的一致性,尤其是在语言等认知功能方面;然而,tb-fMRI的一致性通常大于rs-fMRI。术前功能磁共振成像,结合MRI束成像和术中DCS,可以提高生存率和切除范围,减少功能缺陷。功能磁共振成像有可能指导手术计划并帮助确定术中标测的目标,但目前关于其对患者预后影响的前瞻性证据有限。这篇综述描述了功能磁共振成像在脑肿瘤切除术前评估中的现状。关键词:MR功能成像,中枢神经系统,脑/脑干,解剖学,肿瘤学,功能MRI,功能解剖学,基于任务的,静息状态,手术计划,脑肿瘤©RSNA,2023。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Current State of Functional MRI in the Presurgical Planning of Brain Tumors.

Surgical resection of brain tumors is challenging because of the delicate balance between maximizing tumor removal and preserving vital brain functions. Functional MRI (fMRI) offers noninvasive preoperative mapping of widely distributed brain areas and is increasingly used in presurgical functional mapping. However, its impact on survival and functional outcomes is still not well-supported by evidence. Task-based fMRI (tb-fMRI) maps blood oxygen level-dependent (BOLD) signal changes during specific tasks, while resting-state fMRI (rs-fMRI) examines spontaneous brain activity. rs-fMRI may be useful for patients who cannot perform tasks, but its reliability is affected by tumor-induced changes, challenges in data processing, and noise. Validation studies comparing fMRI with direct cortical stimulation (DCS) show variable concordance, particularly for cognitive functions such as language; however, concordance for tb-fMRI is generally greater than that for rs-fMRI. Preoperative fMRI, in combination with MRI tractography and intraoperative DCS, may result in improved survival and extent of resection and reduced functional deficits. fMRI has the potential to guide surgical planning and help identify targets for intraoperative mapping, but there is currently limited prospective evidence of its impact on patient outcomes. This review describes the current state of fMRI for preoperative assessment in patients undergoing brain tumor resection. Keywords: MR-Functional Imaging, CNS, Brain/Brain Stem, Anatomy, Oncology, Functional MRI, Functional Anatomy, Task-based, Resting State, Surgical Planning, Brain Tumor © RSNA, 2023.

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