An Assessment of Current Brain Targets for Deep Brain Stimulation Surgery With Susceptibility-Weighted Imaging at 7 Tesla
An Assessment of Current Brain Targets for Deep Brain Stimulation Surgery With Susceptibility-Weighted Imaging at 7 Tesla
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DOI：
10.1227/neu.0b013e3181f74105
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发表时间：
2010-12-01
期刊：
影响因子：
4.8
通讯作者：
Harel, Noam
中科院分区：
文献类型：
--
作者：
Abosch, Aviva;Yacoub, Essa;Harel, Noam
背景：脑深部电刺激（DBS）手术用于治疗运动障碍，包括帕金森病、原发性震颤和肌张力障碍。成功的DBS手术关键取决于DBS电极在目标结构中的精确放置。DBS手术通常依赖于叠加在患者脑磁共振成像（MRI）扫描上的标准化图谱衍生图，然后进行微电极记录和宏刺激以细化最终电极位置。微电极记录有出血的风险，需要患者在手术过程中积极参与。目的：使用高场MRI增强DBS手术的解剖成像，最终目标是提高解剖靶点选择的准确性。方法：使用7-T MRI扫描仪结合使用多种图像对比的采集方案阵列，我们获得了健康受试者深部核团的高分辨率图像。结果：使用磁共振加权成像在7 T体内获得的上级图像分辨率和对比度显著改善了DBS靶的解剖描绘，并允许识别这些靶内的内部结构。每个目标区域的患者特定的，3维模型的基础上产生的所获得的images.CONCLUSION：MRI在7 T的技术发展已经取得了改善的解剖分辨率的脑深部结构，从而持有的承诺，提高解剖为基础的DBS手术的目标。未来的研究需要验证这种技术在提高DBS手术中的靶向准确性。
BACKGROUND: Deep brain stimulation (DBS) surgery is used for treating movement disorders, including Parkinson disease, essential tremor, and dystonia. Successful DBS surgery is critically dependent on precise placement of DBS electrodes into target structures. Frequently, DBS surgery relies on normalized atlas-derived diagrams that are superimposed on patient brain magnetic resonance imaging (MRI) scans, followed by microelectrode recording and macrostimulation to refine the ultimate electrode position. Microelectrode recording carries a risk of hemorrhage and requires active patient participation during surgery.OBJECTIVE: To enhance anatomic imaging for DBS surgery using high-field MRI with the ultimate goal of improving the accuracy of anatomic target selection.METHODS: Using a 7-T MRI scanner combined with an array of acquisition schemes using multiple image contrasts, we obtained high-resolution images of human deep nuclei in healthy subjects.RESULTS: Superior image resolution and contrast obtained at 7 T in vivo using susceptibility-weighted imaging dramatically improved anatomic delineation of DBS targets and allowed the identification of internal architecture within these targets. A patient-specific, 3-dimensional model of each target area was generated on the basis of the acquired images.CONCLUSION: Technical developments in MRI at 7 T have yielded improved anatomic resolution of deep brain structures, thereby holding the promise of improving anatomic-based targeting for DBS surgery. Future study is needed to validate this technique in improving the accuracy of targeting in DBS surgery.