MODERN METHODS OF DIAGNOSIS AND TREATMENTОF MALIGNANT TUMORS (GLIOMAS) OF THE BRAIN
Keywords:
CNS tumors, gliomas, MRI DT-tractography, PET, quality of lifeAbstract
Aim. Development of a complex of topical diagnostics and a differentiated approach to surgical treatment of malignant brain tumors based on the use of modern neuroimaging
Material and methods. The article describes modern diagnostic methods (MRI, DT_tractography, PET and a differentiated approach to the treatment of malignant tumors (gliomas) of the brain. The authors present algorithms for diagnosis, treatment and monitoring of patients with intracerebral gliomas. The role of DT tractography in planning, choosing a surgical approach, and the extent of resection is described brain gliomas.
Results. Visualization of the pathways of the brain using the DT-tractography method made it possible to clarify the optimal direction of the axis of surgical action, so as not to injure the preserved pathways, and thereby help in choosing the optimal surgical access. However, when choosing surgical access, intraoperatively occurring brain displacement should be taken into account. Therefore, when choosing the tactics of surgical removal of malignant gliomas, we adhered to the principle of anatomical accessibility and physiological permissibility. Today, most patients with focal neurological symptoms, after surgical removal of glioma, have regression of neurological symptoms. Postoperative mortality, even for glioblastomas, approaches 1%, and deterioration of the condition is approximately 5%. The best results are achieved after radical removal in comparison with partial resection of the tumor or its biopsy. The development of innovative methods of modern diagnostics and treatment today, allow us neurosurgeons to successfully perform radical surgical interventions of malignant gliomas in most cases.
Conclusions. The developed complex of topical diagnostics and selection of surgical tactics for the removal of malignant brain tumors makes it possible to reduce damage to the motor pathways of the brain and increase the radicality of the operation. Treatment of malignant brain gliomas is complex. Depending on the histological structure and growth pattern of glioma, surgical, radiation and chemotherapy treatment should be used. Providing medical care according to the proposed algorithm will make it possible to select the optimal therapy for patients with brain gliomas in each specific case, which directly affects the duration and quality of life of patients.
References
Гринберг М.С. Нейрохирургия/ Марк С.Г.: пер. с англ. – М.: МЕДпресс-информ, 2010. -1008 с.
Коновалов В.Н., Корниенко В.Н., Потапов А.А. и др. Общие принципы диагностики и лечения глиом головного мозга. Глава № 2 // В книге: Флюоресцентная навигация и лазерная спектроскопия в хирургии глиом головного мозга. Горяйнов С, Потапов А., Лощенков В., Савельева Т. - Москва, Медиа Сфера, 2014. – С. 23-31.
Короткевич Е.А., Ашуров Р.Г., Сидорович А.Р. // Кумулятивная выживаемость взрослых пациентов после комбинированного лечения глиом головного мозга с применением современных периоперационных технологий// Евразийский онкологический журнал, 2016. - № 1 (8). - С. 17-27.
Короткевич Е.А., Ашуров Р.Г., Сидорович А.Р., Антоненко А.И. /Магнитно-резонансная спектроскопия и диффузионно-тензорная трактография в хирургии внутримозговых опухолей // Инновационные технологии в медицине, 2015. - № 4 (7). - С. 90-100.
Потапов А.А., Горяйнов С.А., Жуков В.Ю., Пицхелаури Д.И., Кобяков Г.Л., Пронин И.Н., Захарова Н.Е., Тоноян А.С., Огурцова А.А., Буклина СБ., Меликян З.А. Длинные ассоциативные пути белого вещества головного мозга: современный взгляд с позиции нейронаук // Вопросы нейрохирургии им.Н.Н.Бурденко, 2014. – Т 78. - №5. – С. 66-77.
Хайдарова Дилдора Кадировна, Хотамова Сарвиноз Муйитдиновна. Сурункали мия ишемиясининг клиник ва нейровизуал мезонлари. Журнал неврологии и нейрохирургических исследований. №1. 2024 С.43
Робак К.О., Чувашова О.Ю., Главацкий А.Я. Применение данных диффузионно-тензорной томографии и МР-трактографии в нейрохирургии глиом двигательной зоны головного мозга // Неврология и нейрохирургия Восточная Европа, 2016. - № 3 (31). - С. 341-346.
Современные технологии и клинические исследования в нейрохирургии // Под ред. А.Н. Коновалова. – Т. 3. – М., 2012. – 320 с.
Савинцева Ж.И., Скворцова Т.Ю., Бродская З.Л. Современные методы нейровизуализации в дифференциальной диагностике лучевых поражений головного мозга у больных с церебральными опухолями // Лучевая диагностика и терапия – 2012. – Т.3. - №.1. – С. 15–23.
Kazunori Oda, F. Yamaguchi, H. Enomoto, T. Higuchi, A.Morita. Prediction of recovery from supplementary motor area syndrome after brain tumor surgery: preoperative diffusion tensor tractography analysis and postoperative neurological clinical course // Neurosurg Focus, 2018. - Vol. 44 (1-6):E3.
Louis DN. et al. The 2016 WHO classification of tumors of the central nervous system. – 2016. – Vol. 114(2). – pp. 1545-1553.
Martino J., Mato D., E. Marco de Lucas, J.A. García-Porrero, A. Gabarrós, A. Fernández-Coello, A.Vázquez-Barquero. Subcortical anatomy as an anatomical and functional landmark in insulo-opercular gliomas // J. Neurosurg., 2015. – Vol. 123. – pp. 1081–1092.
Monica Bucci, Maria Luisa Mandelli, Jeffrey I. Berman, Bagrat Amirbekian, Christopher Nguyen, Mitchel S. Berger, and Roland G. Henry Quantifying diffusion MRI tractography of the corticospinal tract in brain tumors with deterministic and probabilistic methods // Neuroimage Clin., 2013. – Vol. 3. – pp. 361-368.
Sollmann N., Kelm A., Ille S., Schröder A., Zimmer C., Ringel F., Meyer B., Krieg S.M. Setup presentation and clinical outcome analysis of treating highly language-eloquent gliomas via preoperative navigated transcranial magnetic stimulation and tractography // Neurosurg Focus., 2018. – Vol. 44 (6).E:2.
Sollmann N., Wildschuetz N., Kelm A., Conway N., Moser T., Bulubas L., Kirschke J.S., Meyer B., Krieg S.M. Associations between clinical outcome and navigated transcranial magnetic stimulation characteristics in patients with motor-eloquent brain lesions: a combined navigated transcranial magnetic stimulation–diffusion tensor imaging fiber tracking approach // Journal of Neurosurgery, 2018. - Vol. 128, N 3. – pp. 800-810.
Vanderauwera J., De Vos A., Forkel S.J., Catani M., Wouters J., Vandermosten M., Ghesquière P. Neural organization of ventral white matter tracts parallels the initial steps of reading development: A DTI tractography study // Brain Lang., 2018. – Vol. 183. – pp. 32-40.
Xie, Sangma; Zuo, Nianming; Shang, Liqing; Song, Ming; Fan, Lingzhong; Jiang, Tianzi How Does B-Value Affect HARDI Reconstruction Using Clinical Diffusion MRI Data? - Source: PLoS ONE, 2015. - Vol. 10, Issue 3. – pp. 1-19.
Yamaguchi F., Ten H., Higuchi T., Omura T., Kojima T., Adachi K., Kitamura T., Kobayashi S., Takahashi H., Teramoto A., Morita. An intraoperative motor tract positioning method in brain tumor surgery: technical note// J. Neurosurg., 2018. – Vol. 129 (3). – pp. 576-582.
Dieterich S., Rodgers J., Chan R. Radiosurgery Image-Guided Interventions / Eds. T. Peters, K. Cleary. — N.Y.: Springer Science; Business Media, LLC, 2018. — Chapter 16. — P.461–500.
