静息态独立成分分析在累及运动区脑肿瘤患者术前评价中的应用

Application of independent component analysis in presurgical planning for patients with motor area brain tumors

目的将静息态功能连接成像及独立成分分析处理方法引入神经外科,作为脑肿瘤切除术前制定手术方案的一种辅助手段。方法通过采集其术前静息态功能成像及手指运动任务下功能成像数据,分析比较了3例累及运动区的脑胶质瘤患者的功能区定位情况,利用固有连接得到激活分布和手动任务下激活图,并采用唤醒术中皮层电刺激的方法确定了手指运动区。结果通过固有连接相关分析得到的感觉运动区的位置与任务下磁共振成像显示的感觉运动区位置相似,并与术中皮层电刺激得到的精确定位相一致。3例患者术后运动功能保留良好。结论静息态功能连接成像是术前定位患者皮层重要功能区及辅助制定外科手术计划的有效手段。其与术中直接电刺激技术得到的结果具有很好的一致性。同时,这项技术与传统的任务下功能磁共振成像相比,有更加广泛的临床适应对象。

Objective To introduce a functional image technique using resting state correlation mapping and independent component analysis （ICA） as a potential aid for presurgieal planning of brain tumor resection. Methods Three patients with brain tumors involving the motor area participated in this study. We compared the resting state correlation mapping to task elicited activation obtained by functional magnetic resonance imaging （fMRI） scanning. All the 3 patients received the awake craniotomy and their hand functional cortex were marked using direct cortical stimulation intraoperatively. Results The hand motor area defined based on the spontaneous activity correlation mapping were similar to the area localized by finger movement tasks, and also consistent with cortical stimulation mapping. All of the patients had good motor function postoperatively. Conclusions Resting state correlation mapping is feasible to localize the sensorimotor cortex in patients for presurgieal planning. Such method correlates well with direct cortical stimulation and provides more applicable opportunities on clinical patients in comparison to traditional task-elicit fMRI.