OPTIMIZATION OF SURGICAL APPROACH IN PATIENTS WITH TUMORS OF MOTOR ZONE OF THE CEREBRAL CORTEX ON THE BASIS OF TRANSCRANIAL MAGNETIC STIMULATION AND MAGNETIC RESONANCE TRACTOGRAPHY
https://doi.org/10.24884/0042-4625-2015-174-6-63-67
Abstract
Preoperative planning on the basis of combined data of navigated transcranial magnetic stimulation and MR-tractography give an opportunity to choose an optimal treatment approach in each clinical case. There were performed the examinations in 52 patients with tumors situated in projection of central gyrus. The neurosurgical interference was admitted as inappropriate in 3 (5,8%) patients. The volume of planned operation was reduced in 14 (26,9%) cases. The examination of 15 (28,9%) patients allowed choice of the correct access trajectory. The navigated transcranial magnetic stimulation assisted in performance of more safe removal of neoplasms closed to the functionally meaningful zones of the brain in 20 (38,4%).
About the Authors
A. Yu. Shcherbuk
Saint-Petersburg State University; Saint-Petersburg clinical research-practical center of specialized types of medical aid (oncological)
Russian Federation
Russian Federation
M. E. Eroshenko
Saint-Petersburg State University; Saint-Petersburg clinical research-practical center of specialized types of medical aid (oncological)
Russian Federation
Russian Federation
Yu. A. Shcherbuk
Saint-Petersburg State University
Russian Federation
Russian Federation
References
1. Баарс Б., Гейдж Н. Мозг, познание, разум: введение в когнитивные нейронауки: в 2 ч. / Под ред. Б. Баарса, Н. Гейдж; пер. с англ. под ред. проф. В. В. Шульговского. М.: БИНОМ, Лаборатория знаний, 2014. Ч. 1. 544 с.
2. Баарс Б., Гейдж Н. Мозг, познание, разум: введение в когнитивные нейронауки: в 2 ч. / Под ред. Б. Баарса, Н. Гейдж; пер. с англ. под ред. проф. В. В. Шульговского. М.: БИНОМ, Лаборатория знаний, 2014. Ч. 2. 464 с.
3. Коновалов А. Н., Потапов А. А., Гаврилов А.Г и др. Современные технологии в нейрохирургии // Современные технологии и клинические исследования в нейрохирургии / Под ред. А. Н. Коновалова. М., 2012. Т. I. С. 55-111.
4. Лошаков В. А., Пицхелаури Д. И., Кобяков Г. Л. и др. Глиомы // Современные технологии и клинические исследования в нейрохирургии / Под ред. А. Н. Коновалова. М., 2012. Т. II. С. 15-38.
5. Труфанов Г. Е., Рамешвили Т. Е., Дергунова Н. И. и др. Совмещенная позитронно-эмиссионная и компьютерная томография (ПЭТ-КТ) в диагностике опухолей головного мозга. СПб.: ЭЛБИ-СПб, 2005. 93 с.
6. Щербук Ю. А., Щербук А. Ю. Современные организационные, хирургические и реабилитационные технологии в нейроонкологии. СПб.: СПбГУ, 2014. 263 с.
7. Bello L., Riva M., Fava E. et al. Tailoring neurophysiological strategies with clinical context enhances resection and safety and expands indications in gliomas involving motor pathways // Neuro Oncol. 2014. Vol. 16. P. 1110-1128.
8. Forster M. T., Senft C., Hattingen E. et al. Motor cortex evaluation by nTMS after surgery of central region tumors: a feasibility study // Acta Neurochir. (Wien). 2012. Vol. 154. P. 1351-1359.
9. Frey D., Schilt S., Strack V. et al. Navigated transcranial magnetic stimulation improves the treatment outcome in patients with brain tumors in motor eloquent locations // Neuro Oncol. 2014. Vol. 16. P. 1365-1372.
10. Frey D., Strack V., Wiener E. et al. A new approach for corticospinal tract reconstruction based on navigated transcranial stimulation and standardized fractional anisotropy values // Neuroimage. 2012. Vol. 62. P. 1600-1609.
11. Krieg S. M., Sabih J., Bulubasova L. et al. Preoperative motor map ping by navigated transcranial magnetic brain stimulation improves outcome for motor eloquent lesions // Neuro Oncol. 2014. Vol. 16. P. 1274-1282.
12. Krieg S. M., Shiban E., Buchmann N. et al. Presurgical navigated transcranial magnetic brain stimulation for recurrent gliomas in motor eloquent areas // Clin. Neurophysiol. 2013. Vol. 124, № 3. P. 522-527.
13. Nimsky C., Ganslandt O., Hastreiter P. et al. Preoperative and intraoperative diffusion tensor imaging-based fiber tracking in glioma surgery // Neurosurgery. 2005. Vol. 56. P. 130-138.
14. Ottenhausen M., Krieg S. M., Meyer D., Ringel F. Functional preoperative and intraoperative mapping and monitoring: increasing safety and efficacy in glioma surgery // Neurosurg. Focus. 2015. Vol. 38, № 1. P. E3.
15. Picht T., Schulz J., Hanna M. et al. Assessment of the influence of navigated transcranial magnetic stimulation on surgical planning for tumors in or near the motor cortex // Neurosurgery. 2012. Vol. 70, № 5. P. 1248-1257.
16. Takahashi S., Vajkoczy P., Picht T. Navigated transcranial magnetic stimulation for mapping the motor cortex in patients with rolandic brain tumors // Neurosurg. Focus. 2013. Vol. 34, № 4. P. E3.
17. Tarapore P.E., Tate M. C., Findlay A. M. et al. Preoperative multimodal motor mapping: a comparison of magnetoencephalography imaging, navigated transcranial magnetic stimulation, and direct cortical stimulation // J. Neurosurg. 2012. Vol. 117. P. 354-362.
18. Wu J. S., Zhou L. F., Tang W. J. et al. Clinical evaluation and follow-up outcome of diffusion tensor imaging-based functional neuronavigation: a prospective, controlled study in patients with gliomas involving pyramidal tracts // Neurosurgery. 2007. Vol. 61. P. 935-949.
Review
For citations:
Shcherbuk A.Yu., Eroshenko M.E., Shcherbuk Yu.A. OPTIMIZATION OF SURGICAL APPROACH IN PATIENTS WITH TUMORS OF MOTOR ZONE OF THE CEREBRAL CORTEX ON THE BASIS OF TRANSCRANIAL MAGNETIC STIMULATION AND MAGNETIC RESONANCE TRACTOGRAPHY. Grekov's Bulletin of Surgery. 2015;174(6):63-67. (In Russ.) https://doi.org/10.24884/0042-4625-2015-174-6-63-67
Views:
436
Email this article 