Three-dimensional visualization of subdural electrodes for presurgical planning.
Three-dimensional visualization of subdural electrodes for presurgical planning.
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DOI：
10.1227/neu.0b013e31820783ba
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发表时间：
2011-03
期刊：
影响因子：
4.8
通讯作者：
Mueller W
中科院分区：
文献类型：
--
作者：
LaViolette PS;Rand SD;Raghavan M;Ellingson BM;Schmainda KM;Mueller W
对于难治性癫痫患者，植入硬膜下电极进行脑电检查的准确定位和可视化仍然是一个具有挑战性的临床问题。我们介绍了一种用电极覆盖创建精确的三维(3D)脑模型的技术，这是切除手术计划的理想选择。我们的程序使用植入后磁共振成像(MRI)和计算机断层成像(CT)成像来创建受压迫影响的大脑的3D模型，并使用免费软件创建强度阈值CT衍生电极模型。为了更好地显示横跨沟槽的电极，还描述了电极下方的足迹或“阴影”。将电极模型与术中摄影进行比较，以验证其有效性。与照片相比，在患者特定的移植后MRI脑成像上真实地呈现出颅内电极的位置是可靠的，并被证明是准确的。使用我们的渲染技术，放置在半球间的电极也是可见的。电极阴影在定位横跨脑沟的电极时很有用。我们提出了一种在受脑压迫影响的3D模型上显示硬膜下电极的准确方法，为手术计划提供了一个理想的平台。
Accurate localization and visualization of subdural electrodes implanted for intracranial electroencephalography in cases of medically refractory epilepsy remains a challenging clinical problem. We introduce a technique for creating accurate 3-dimensional (3D) brain models with electrode overlays, ideal for resective surgical planning. Our procedure uses postimplantation magnetic resonance imaging (MRI) and computed tomographic (CT) imaging to create 3D models of compression-affected brain combined with intensity-thresholded CT-derived electrode models using freely available software. Footprints, or “shadows,” beneath electrodes are also described for better visualization of sulcus-straddling electrodes. Electrode models were compared with intraoperative photography for validation. Realistic representations of intracranial electrode positions on patient-specific postimplantation MRI brain renderings were reliably created and proved accurate when compared with photographs. Electrodes placed interhemispherically were also visible with our rendering technique. Electrode shadows were useful in locating electrodes that straddle sulci. We present an accurate method for visualizing subdural electrodes on brain compression effected 3D models that serves as an ideal platform for surgical planning.