基于MR图像的苍白球内侧部帕金森手术靶点坐标定位

Locating the coordinates of globus pallidus internus using MR imaging-based method in Parkinson's disease surgery

外科治疗是帕金森病(Parkinson's disease,PD)治疗中必不可少的一部分,尤其对服药5~8年出现药物时效降低或药物所致异动症的患者更是如此,目前以苍白球内侧部(globus pallidus internus,GPi)为手术靶点的脑损毁术及深部脑刺激术(deep brain stimulation,DBS)是治疗PD常用的有效方法。GPi的精确定位是实施上述手术的关键,对术后疗效的好坏有着极大的影响。为了实现对靶点目标的精准定位,GPi经历了由间接定位的Atlas-based方法到直接定位的MR imaging-based方法的发展与改变。其中MRI技术在GPi定位方法发展中起着举足轻重的作用,可以说没有MRI技术的飞速发展,也就不会有基于高分辨率MR图像的GPi直接定位方法出现。因此作者不仅对近20年GPi的手术坐标位置进行了回顾性总结,试图确定具一般适用意义的GPi坐标,而且介绍了MRI技术在GPi靶点定位手术中的应用及发展。

Surgery for Parkinson＇s disease is an indispensable part among all kinds of treatments, especially for patient who has showed signs of drug resistance or side effects after five to eight years of medication history. Deep brain stimulation surgery taking globus pallidus internus（GPi） as target has become a common and effective way to treat Parkinson＇s disease. The precisely defined location of GPi target is the key point to perform a successful surgery. For achieving the goal of accurately locating surgery targets, GPi locating method experiences two stages from indirect Atlasbased method stage to direct MR imaging-based method stage, during which magnetic resonance imaging technology plays a pivotal role. The fast development of magnetic resonance imaging technology is the necessary prerequisite to direct MR imagingbased method. Based on these considerations above, this paper conducted a systematic review on both the GPi surgery target location and application of magnetic resonance imaging technology in Parkinson＇s disease surgery for last two decades.