neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.63769/1683-3295-2017-0-2-3-10neurosurgery-396Research ArticleЛЕКЦИЯLECTUREПрименение функциональной магнитно-резонансной томографии головного мозга в нейрохирургииThe usage of functional magnetic resonance imaging of brain in neurosurgeryТокаревАлексей СергеевичTokarevA. S.mail@rssklif.ruСтепановВалентин НиколаевичStepanovV. N.noemail@neicon.ruШатохинаЮлия ИвановнаShatokhinaYu. I.noemail@neicon.ruЧувилинСтанислав АлександровичChuvilinS. A.noemail@neicon.ruШалумовАрнольд ЗироевичShalumovA. Z.noemail@neicon.ruГБУЗ «НИИ скорой помощи им. Н.В. Склифосовского ДЗМ г. Москвы»Russian Federation20172411201702310Copyright © Токарев А.С., Степанов В.Н., Шатохина Ю.И., Чувилин С.А., Шалумов А.З., 20172017Токарев А.С., Степанов В.Н., Шатохина Ю.И., Чувилин С.А., Шалумов А.З.Tokarev A.S., Stepanov V.N., Shatokhina Y.I., Chuvilin S.A., Shalumov A.Z.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/396

Функциональная магнитно-резонансная томография (фМРТ) - современный неинвазивный, не сопровождающийся ионизирующим излучением, метод нейровизуализации, который позволяет локализовать зоны головного мозга, ответственные за выполнение различных функций. Физиологические принципы фМРТ основаны на регистрации слабовыраженных гемодинамических изменений, происходящих в головном мозге во время его активации. Применение фМРТ на предоперационном этапе позволяет уточнить тактику, с целью сохранения элоквентных зон головного мозга, что является одной из важнейших задач нейрохирургии. За последние 10 лет методику широко внедряют в практику и используют как на предоперационном этапе, так и во время операции у пациентов с объемными образованиями головного мозга и другой нейрохирургической патологией, например фармакорезистентной эпилепсией. В будущем совмещение анатомических МР-изображений высокого разрешения и данных функциональных исследований, таких как электроэнцефалография и фМРТ, будет способствовать выявлению и подробному изучению таких патологических изменений, диагностика которых в настоящий момент затруднена. К примеру, станет возможным определение патологических сетей, ответственных за формирование эпилептической активности в головном мозге, что позволит планировать нейрохирургическое оперативное вмешательство, направленное на их устранение.

Functional magnetic resonance imaging (fMRI) is a modern, non-invasive method of the neurovisualisation allowed measuring and localizing specific areas of the human brain, responsible for some functions, without application of radiation. Physiological principles of fMRI are based on detecting of small changes in blood flow in the brain areas in response to increasing demands during metabolic activation. This technique has grown rapidly in popularity over the past decade and is being used increasingly in neurosurgery for both preoperative planning and intraoperative neurosurgical decision making in patients with brain tumors and other neurosurgical pathologies such as intractable epilepsy. If the patient needs tumor resection or removing a portion of the brain responsible for initiating epileptic seizures, the preservation of functions during operation is an essential goal of neurosurgery and fMRI allows planning surgical approach that will spare as much of these areas as possible. The combined registration of high resolution anatomic and physiological data from multiple complementary sources such like electroencephalogram (EEG) and fMRI, which provide insights into the networks underlying seizure generation will be used to investigate many pathological processes and plan more neurosurgical procedures in the future.

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