帕金森病定向术磁共振靶点定位

The study of MRI target imaging on Vim radiofrequency lesions of Parkinson's disease

目的 探讨帕金森病立体定向术核磁共振靶点定位最佳扫描方式。方法 72例帕金森病患者行磁共振导向结合微电极记录定位 ,丘脑腹中间核 (Vim)毁损术。分为两组 ,采用中反转恢复序列 (IR)扫描直视定位和常规自旋回波 (SE)扫描解剖间接定位。以术中微电极记录和射频刺激验证确定的毁损靶点为标准 ,观察毁损靶点与影像定位靶点坐标的一致性 ,统计两种MRI定位方式下预定靶点与毁损靶点坐标符合率 ,结合疗效分析评价两种定位法。结果 34例行IR扫描直视定位术中靶点符合率为 88.2 % ,38例行SE扫描间接定位术中靶点符合率为 31.6 %。两种定位法存在显著差异 (P <0 .0 5 )。MRI直视定位较解剖间接定位电生理靶点符合率高。结论 IR序列是MRI帕金森病立体定向靶点影像定位的优选扫描方式。其个体化直视定位靶点对提高疗效。

Objective To optimize the accuracy of initial magnetic resonance imaging based stereotactic which helps targeting for Parkinson's disease surgery.Methods 72 consecutive cases using the Vim target were studied.Localization of these nuclei was performed using the Leksell stereotactic head frame and inversion recovery sequences (IR,34 cases)or T 1-weighted spin echo sequences(SE,38 cases).Targeting accuracy and individual variation in the spatial coordinates of these structures were independently measured by identification of nuclear boundaries during microelectrode penestration.Results Initial target localization baesd on IR direct visualaization was more accurate than that obtained by usingindirect location using SE imaging.Conclusion IR Magnetic resonance imaging based initial stereotactic targeting of Vim,based on direct visualization of the target boundaries leads to better target accuracy compared with SE MRI imaging methods.