Department of Neuroradiology, King's College Hospital, Denmark Hill, London, SE5 9RS, UK.
Eur Radiol. 2011 Jan;21(1):130-6. doi: 10.1007/s00330-010-1885-5. Epub 2010 Jul 21.
Reliable identification of the subthalamic nucleus (STN) and globus pallidus interna (GPi) is critical for deep brain stimulation (DBS) of these structures. The purpose of this study was to compare the visibility of the STN and GPi with various MRI techniques and to assess the suitability of each technique for direct stereotactic targeting.
MR images were acquired from nine volunteers with T2- and proton density-weighted (PD-W) fast spin echo, susceptibility-weighted imaging (SWI), phase-sensitive inversion recovery and quantitative T1, T2 and T2* mapping sequences. Contrast-to-noise ratios (CNR) for the STN and GPi were calculated for all sequences. Targeting errors on SWI were evaluated on magnetic susceptibility maps. The sequences demonstrating the best conspicuity of DBS target structures (SWI and T2*) were then applied to ten patients with movement disorders, and the CNRs for these techniques were assessed.
SWI offers the highest CNR for the STN, but standard PD-W images provide the best CNR for the pallidum. Susceptibility maps indicated that the GPi margins may be shifted slightly on SWI, although no shifts were seen for the STN.
SWI may improve the visibility of the STN on pre-operative MRI, potentially improving the accuracy of direct stereotactic targeting.
可靠地识别丘脑底核（STN）和苍白球内侧部（GPi）对于这些结构的深部脑刺激（DBS）至关重要。本研究的目的是比较各种 MRI 技术对 STN 和 GPi 的显示效果，并评估每种技术用于直接立体定向靶向的适用性。
从 9 名志愿者中采集 T2 和质子密度加权（PD-W）快速自旋回波、磁化率加权成像（SWI）、相位敏感反转恢复和定量 T1、T2 和 T2* 映射序列的 MR 图像。计算所有序列中 STN 和 GPi 的对比噪声比（CNR）。在磁化率图上评估 SWI 上的靶向误差。然后将显示 DBS 靶结构最佳显影效果的序列（SWI 和 T2*）应用于 10 名运动障碍患者，并评估这些技术的 CNR。
SWI 提供 STN 的最高 CNR，但标准 PD-W 图像提供 GPi 的最佳 CNR。磁化率图表明，SWI 上的 GPi 边缘可能略有移位，但 STN 未见移位。
SWI 可能会提高术前 MRI 中 STN 的可见度，从而提高直接立体定向靶向的准确性。
