Development of an ultrafast brain MR neuronavigation protocol for ventricular shunt placement.
Development of an ultrafast brain MR neuronavigation protocol for ventricular shunt placement.
复制标题
开发用于心室分流放置的超快脑MR神经训练方案。
DOI：
10.3171/2022.5.jns22767
复制
发表时间：
2023-02-01
影响因子：
4.1
通讯作者：
Chiarelli, Peter A.
中科院分区：
文献类型：
--
作者：
Vanstrum, Erik B.;Borzage, Matthew T.;Ha, Joseph;Chu, Jason;Upreti, Meenakshi;Moats, Rex A.;Lai, Lillian M.;Chiarelli, Peter A.
关键词：
磁共振成像技术的进步提供了更好的方法来获取成像数据，并将MRI更无缝地结合到现代儿科外科实践中。其中一种情况是用于儿童神经外科手术的图像引导导航，包括放置颅内导管。图像引导手术(IGS)需要采集CT或MR图像，但前者存在电离辐射的风险，而后者扫描时间较长，通常需要儿科患者服用镇静剂。本项目的目的是通过研究快速磁共振序列在脑室神经导航中的应用，以3个标准为基础：扫描持续时间与CT采集相当、脑室形态可视化、图像配准和表面再现与护理标准相当。这项工作的目的是报告图像的发展，实施，以及在健康受试者中进行配准准确性测试的结果。作者在标准IGS协议的基础上构造了11个候选MR序列，并对各种扫描参数进行了修改，如k空间读出方向、k空间部分采集、k空间稀疏采样(即压缩感知)、面内空间分辨率和层厚。为了评价配准精度，作者计算了目标配准误差(TrE)。选择一个候选序列在10名健康受试者中进行进一步评估。作者确定了一种候选的成像协议，称为用于时间优化的压缩传感的术前成像(PICO)。获取Pico协议需要25秒。作者证实，与默认的MRI神经导航方案(3.35±0.20 mm，p=0.20)相比，Pico的TRE(3.00±0.19 mm)并不逊色。这项工作的开发和测试序列可以实现术中图像的准确配准，并为脑室解剖的可视化提供足够的实质对比。进一步的研究将评估Pico方案在脑室神经导航中作为CT和传统MRI方案的替代品的使用。Https://thejns.org/doi/abs/10.3171/2022.5.JNS22767
Advancements in MRI technology have provided improved ways to acquire imaging data and to more seamlessly incorporate MRI into modern pediatric surgical practice. One such situation is image-guided navigation for pediatric neurosurgical procedures, including intracranial catheter placement. Image-guided surgery (IGS) requires acquisition of CT or MR images, but the former carries the risk of ionizing radiation and the latter is associated with long scan times and often requires pediatric patients to be sedated. The objective of this project was to circumvent the use of CT and standard-sequence MRI in ventricular neuronavigation by investigating the use of fast MR sequences on the basis of 3 criteria: scan duration comparable to that of CT acquisition, visualization of ventricular morphology, and image registration with surface renderings comparable to standard of care. The aim of this work was to report image development, implementation, and results of registration accuracy testing in healthy subjects. The authors formulated 11 candidate MR sequences on the basis of the standard IGS protocol, and various scan parameters were modified, such as k-space readout direction, partial k-space acquisition, sparse sampling of k-space (i.e., compressed sensing), in-plane spatial resolution, and slice thickness. To evaluate registration accuracy, the authors calculated target registration error (TRE). A candidate sequence was selected for further evaluation in 10 healthy subjects. The authors identified a candidate imaging protocol, termed presurgical imaging with compressed sensing for time optimization (PICO). Acquisition of the PICO protocol takes 25 seconds. The authors demonstrated noninferior TRE for PICO (3.00 ± 0.19 mm) in comparison with the default MRI neuronavigation protocol (3.35 ± 0.20 mm, p = 0.20). The developed and tested sequence of this work allowed accurate intraoperative image registration and provided sufficient parenchymal contrast for visualization of ventricular anatomy. Further investigations will evaluate use of the PICO protocol as a substitute for CT and conventional MRI protocols in ventricular neuronavigation. https://thejns.org/doi/abs/10.3171/2022.5.JNS22767