帕金森病手术相关靶点MRI定位解剖的研究

Anatomical study of relative targets MRI localization in Parkinson's disease

目的探讨MRI定位帕金森病手术相关靶点的准确性和实用性。方法采用T1序列对76例活体人脑前后连合间径(LI)在MRI上的长度进行测量;采用自旋回波翻转恢复序列和T2序列对10名健康人以LI为扫描基线,行3mm层厚、无间距的矢状位、轴位和冠状位头部MRI扫描,分析帕金森病手术相关靶点的MRI位置、影像学特点。结果76例活体人脑MRI上的LI平均长度为22.90±1.30mm;丘脑底核(STN)和苍白球内侧部(GPi)在MRI上清晰显示,其靶点坐标STN为中线旁开12.01±1.25mm,原点后0.62±1.07mm,AC-PC平面下3mm;GPi为中线旁开19.99±1.48mm,原点前3mm,AC-PC平面下3.20±1.24mm。腹内侧中间核(Vim)为MRI不可见靶点,但可根据AC、PC、AC-PC连线和三脑室进行直观、简便的推算。结论MRI可直接、准确地显示脑内一些帕金森病手术相关靶点。

Objective To explore accuracy of MRI localization in some Parkinson's disease targets including AC, PC, STN, GPi and Vim. Methods Intercommissural line(LI)lengths on MRI scanned by T1 sequence of 76 vital brains were measured; 3-mm-thick, sagittal, axial and coronal MRI of 10 healthy people were also acquired by fast spin echo inversion recovery and T2-weighted imaging sequence, based on the LI reference. The MRI features and localizations of some intracranial targets were studied. Results The average length of MRI LI of 76 vital brains was 22.90±1.30mm. The STN and GPi were directly targeted from MRI. The STN target was 12.01±1.25mm lateral to midline, 0.62±1.07mm posterior to the midcommissural point and 3mm inferior to the AC-PC line; GPi target was 19.99±1.48mm lateral to midline,3mm anterior to the midcommissural point and 3.20±1.24mm inferior to the AC-PC line. Vim target was not directly visualized from MRI, but can be located indirectly based on anatomical marks ,such as AC, PC, AC-PC line and the third ventricle. Conclusion The LI is a scientific reference of cerebral targets for stereotactic neurosurgery. Some cerebral targets for Parkinson's disease can be accurately targeted from MRI alone and make it possible for individual locations of targets.