帕金森病脑深部电刺激电极位置的回顾性分析

Detection of electrode position in deep brain stimulation therapy in patients with Parkinson′s disease:A retrospective analysis

目的:回顾性分析比较帕金森病(Parkinson′s disease,PD)脑深部电刺激(deep brain stimulation,DBS)术后,短期内(1周内)CT检查与远期MRI扫描图像所示电极位置的准确性,评价2种方法的临床实用价值。方法:获取PD患者术后1周内的CT图像及术后1~12个月的MRI图像,将前者与术前MRI图像进行融合,分别测量融合图像和单纯术后MRI图像显示的DBS电极末端位置,比较2种方法间的误差。结果:全部患者均于术后1周内进行CT检查,并将CT与术前MRI融合,其中14例患者于术后1~12个月行MRI检查,分析53例CT融合图像与14例MRI图像,结果显示,2种方法间的电极位置定位误差无统计学差异(P>0.05),误差范围为0.42~0.89 mm。结论:将术前MRI图像与术后1周内的CT图像融合,是一种快捷、准确地评价DBS术后电极位置的方法 。

Objective： To assess the value of two methods for the verification of electrode position in deep brain stimulation （DBS） therapy of Parkinson＇s disease （PD）. Compare the accuracy of electrode position detection in images acquired by merging the short-term （within 1 week after the procedure） computed tomography （CT） with preoperative MRI and the long-term （1-12 month or more after the procedure） magnetic resonance imaging （MRI）. Methods： The position of DBS electrode tip was detected under direct vision in fusion images of CT and preoperative 3.0T MRI images as well as in postoperative 1.ST MRI images only. Differences in the two methods were statistically analyzed. Results： Fifty-three fusion images and 14 MRI images showed no significant differences with regard to the position of electrode tips detected, the dif- ference ranging from 0.42 mm to 0.89 mm. Conclusions： The fusion of preoperative MRI and postoperative CT image within 1 week is an effective and efficient approach for detection of DBS electrode position.