Uitti Ryan J, Tsuboi Yoshio, Pooley Robert A, Putzke John D, Turk Margaret F, Wszolek Zbigniew K, Witte Robert J, Wharen Robert E
Department of Neurology, Mayo Clinic, Jacksonville, Florida, FL 32224, USA.
Neurosurgery. 2002 Dec;51(6):1423-28; discussion 1428-31.
To determine whether cranial magnetic resonance imaging (MRI) is associated with deep brain stimulation (DBS) lead displacement or program interference.
In vitro and in vivo studies were performed with the Itrel II implantable pulse generator (IPG) (Model 7424; Medtronic, Minneapolis, MN), Medtronic 3387 and 3389 leads, and a 1.5-T GE Horizon LX scanner (General Electric, Milwaukee, WI). In the in vivo study, two MRI volumetric data sets were compared for each of five patients undergoing staged, bilateral, DBS electrode placement in the thalamic or subthalamic nucleus. The data sets were acquired shortly after the initial implantation and during stereotactic planning for the second implantation (1-8 mo between acquisitions). An additional thalamotomy-treated patient was included as a control patient. Volumetric data were analyzed in a blinded manner, using AnalyzeAVW 3.0 software (Biomedical Imaging Resource, Mayo Clinic, Rochester, MN), to determine lead movement. In the in vitro study, the IPG and leads were positioned in the magnetic field in various configurations and were systematically assessed for movement.
In vivo, the majority of measured deviations (88%) were within the standard error of measurement (1.4 mm). The maximal measured deviation was 3 mm (2% occurrence). Excellent tremor control with stimulation was demonstrated, which did not change after MRI. In vitro, the DBS leads demonstrated no deflection when introduced into the magnetic field. Similarly, no changes in IPG battery strength, lead impedance, or program settings were observed.
MRI was not associated with significant DBS electrode movement or changes in clinical responses. Other IPG models and components and MRI scanners should be evaluated, to develop specific guidelines for MRI among individuals with implanted DBS systems.
确定头颅磁共振成像（MRI）是否与脑深部电刺激（DBS）电极移位或程序干扰相关。
使用Itrel II植入式脉冲发生器（IPG）（型号7424；美敦力公司，明尼阿波利斯，明尼苏达州）、美敦力3387和3389电极，以及一台1.5-T通用电气地平线LX扫描仪（通用电气公司，密尔沃基，威斯康星州）进行体外和体内研究。在体内研究中，对5例接受分期双侧丘脑或丘脑底核DBS电极植入的患者，分别在初次植入后不久以及第二次植入的立体定向规划期间（两次采集间隔1 - 8个月）获取两个MRI容积数据集。另外纳入一名接受丘脑切开术治疗的患者作为对照。使用AnalyzeAVW 3.0软件（生物医学成像资源中心，梅奥诊所，罗切斯特，明尼苏达州）以盲法分析容积数据，以确定电极移动情况。在体外研究中，将IPG和电极以各种配置置于磁场中，并系统评估其移动情况。
在体内，大多数测量偏差（88%）在测量标准误差（1.4毫米）范围内。最大测量偏差为3毫米（发生率2%）。刺激时震颤控制良好，MRI后未发生变化。在体外，DBS电极引入磁场时未出现偏转。同样，未观察到IPG电池强度、电极阻抗或程序设置的变化。
MRI与显著的DBS电极移动或临床反应变化无关。应评估其他IPG型号、组件和MRI扫描仪，以便为植入DBS系统的个体制定MRI的具体指南。
