What factors impact the clinical outcome of magnetic resonance imaging?guided focused ultrasound thalamotomy for essential tremor?
What factors impact the clinical outcome of magnetic resonance imaging?guided focused ultrasound thalamotomy for essential tremor?
复制标题
DOI：
10.3171/2020.2.jns192814
复制
发表时间：
2021-05-01
影响因子：
4.1
通讯作者：
Nakase, Hiroyuki
中科院分区：
文献类型：
--
作者：
Fukutome, Kenji;Kuga, Yoshihiro;Nakase, Hiroyuki
目的磁共振成像？引导聚焦超声（MRgFUS）是治疗特发性震颤（ET）的一种新颖而有用的方法；然而，影响治疗结果的因素尚不清楚。作者进行了这项研究，以确定影响MRgFUS结果的因素。方法2016年5月至2017年8月，15例ET患者入住Ohnishi神经学中心并接受MRgFUS治疗。为了确定影响治疗结果的因素，作者回顾性研究了震颤临床评定量表（CRST）改善率与年龄、病程、基线CRST评分、颅骨密度比（SDR）、颅骨体积、最大传递能量或最高温度之间的相关性。结果平均CRST评分为18.5 ？基线5.8和4.6 ？1年5.7分。CRST评分的改善率为80% ？22%。年龄越小、基线CRST评分越低，CRST改良率越高（p分别为0.025和0.007）。获得CRST改进率？50%，最高温度？55岁吗?C是必要的。SDR与CRST改善率无相关性（p = 0.658）。较低的SDR和较高的颅骨体积要求较高的最大输送能量（p分别= 0.014和0.016）。最高温度越高，病变体积越大（p = 0.026）。结论：较年轻的年龄和较低的基线CRST评分是有利的结局因素。在应用MRgFUS时，评估预测因素非常重要。
OBJECTIVE Magnetic resonance imaging?guided focused ultrasound (MRgFUS) is a novel and useful treatment for essential tremor (ET); however, the factors impacting treatment outcome are unknown. The authors conducted this study to determine the factors affecting the outcome of MRgFUS.METHODS From May 2016 through August 2017, 15 patients with ET were admitted to Ohnishi Neurological Center and treated with MRgFUS. To determine the factors impacting treatment outcome, the authors retrospectively studied correlations between the Clinical Rating Scale for Tremor (CRST) improvement rate and age, disease duration, baseline CRST score, skull density ratio (SDR), skull volume, maximum delivered energy, or maximum temperature.RESULTS The mean CRST score was 18.5 ? 5.8 at baseline and 4.6 ? 5.7 at 1 year. The rate of improvement in the CRST score was 80% ? 22%. Younger age and lower baseline CRST score were correlated with a higher CRST improvement rate (p = 0.025 and 0.007, respectively). To obtain a CRST improvement rate ? 50%, a maximum temperature ? 55?C was necessary. There was no correlation between SDR and CRST improvement rate (p = 0.658). A lower SDR and higher skull volume required significantly higher maximum delivered energy (p = 0.014 and 0.016, respectively). A higher maximum temperature was associated with a significantly larger lesion volume (p = 0.026).CONCLUSIONS Younger age and lower baseline CRST score were favorable outcome factors. It is important to assess predictive factors when applying MRgFUS.