Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, California 90095, USA.
Neurosurgery. 2011 Dec;69(6):1299-306. doi: 10.1227/NEU.0b013e31822b7069.
Introduction of the portable intraoperative CT scanner provides for a precise and cost-effective way of fusing head CT images with high-tesla MRI for the exquisite definition of soft tissue needed for stereotactic targeting.
To evaluate the accuracy of stereotactic electrode placement in patients undergoing deep brain stimulation (DBS) by comparing frame-based postimplantation intraoperative CT (iCT) images fused to a recent 3T-MRI with frame-based postimplantation intraoperative MRI (iMRI) alone.
Frame-based DBS surgeries of 46 targets performed from February 8, 2007 to April 28, 2008 in 26 patients with the use of immediate postimplantation iMRI for target localization were compared with frame-based immediate postimplantation iCT fused with a recent 3T brain MRI for DBS localization of 50 targets performed from August 13, 2008 to February 18, 2010 in 26 patients. Pre- and postoperative mid anterior commissure-posterior commissure line coordinates and XYZ coordinates for preoperatively calculated DBS targets (intended target) and for the permanent DBS lead tips were determined. The differences between preoperative DBS target and postoperative permanent DBS lead-tip coordinates based on postimplantation intraoperative MRI for the MRI-alone group and based on postimplantation intraoperative CT fused to recent preoperative MRI in the CT-MRI group were measured. The t test and Yuen test were used for comparison.
No statistically significant differences were found between the 2 groups when comparing the pre- and postperative changes in mid anterior commissure-posterior commissure line coordinates and XYZ coordinates.
Postimplantation DBS lead localization and therefore targeting accuracy was not significantly different between frame-based stereotactic 1.5T-MRI and frame-based stereotactic head CT fused with recent 3T-MRI.
引入便携式术中 CT 扫描仪为头 CT 图像与高场强 MRI 融合提供了一种精确且具有成本效益的方法，以实现立体定向所需的软组织的精细定义。
通过比较基于框架的植入后术中 CT（iCT）与单独基于框架的植入后术中 MRI（iMRI）融合的头 CT 图像，评估立体定向电极在接受深部脑刺激（DBS）的患者中的放置准确性。
对 2007 年 2 月 8 日至 2008 年 4 月 28 日期间接受框架式 DBS 手术的 26 例患者的 46 个靶点与使用即时植入后 iMRI 进行目标定位的患者进行比较，对 2008 年 8 月 13 日至 2010 年 2 月 18 日期间接受框架式即时植入后 iCT 与最近的 3T 脑部 MRI 融合的 26 例患者的 50 个靶点进行比较。确定术前和术后中前连合-后连合线坐标和 XYZ 坐标，以及术前计算的 DBS 靶点（目标靶点）和永久性 DBS 导联尖端的 XYZ 坐标。比较 MRI 组中基于植入后术中 MRI 的 DBS 目标和术后永久性 DBS 导联尖端坐标之间的差异，以及 CT-MRI 组中基于最近术前 MRI 融合的植入后术中 CT 的差异。使用 t 检验和 Yuen 检验进行比较。
在比较基于框架的立体定向 1.5T-MRI 和基于框架的立体定向头 CT 与最近的 3T-MRI 融合的术前和术后中前连合-后连合线坐标和 XYZ 坐标的变化时，两组之间未发现统计学上的显著差异。
在基于框架的立体定向 1.5T-MRI 和基于框架的立体定向头 CT 与最近的 3T-MRI 融合的 DBS 导联定位和因此的靶向准确性方面，没有显著差异。
