Englot Dario J, Glastonbury Christine M, Larson Paul S
Department of Neurological Surgery, University of California, San Francisco, CA 94143-0112, USA.
Stereotact Funct Neurosurg. 2011;89(5):311-7. doi: 10.1159/000329365. Epub 2011 Aug 31.
Deep brain stimulation (DBS) surgery is a common treatment option for numerous neurological disorders. However, it is not without potential complications, such as hemorrhage and infection. Interestingly, we have observed several instances of abnormal T2-weighted signal hyperintensity surrounding DBS leads on postoperative MRI that are not associated with hemorrhage or infection.
To better characterize the incidence and timing associated with this finding, we retrospectively reviewed postoperative imaging for all DBS implants performed over 9 years at one institution.
Fifteen instances of T2 signal hyperintensity surrounding DBS leads on postoperative MRI scans were observed across 239 implants (6.3% incidence) in 133 patients. The signal characteristics were most consistent with vasogenic edema, possibly representing an inflammatory response. The finding was typically unilateral, even in patients with simultaneous bilateral lead implants. Most affected patients were asymptomatic, although 3 were symptomatic and 1 experienced marked gait instability that was treated with steroids. T2 signal abnormality was seen more commonly in scans obtained 3 or more days after surgery than in those collected immediately postoperatively. No differences in age, anatomical target, diagnosis, or number of microelectrode passes were noted between patients with or without T2 signal. Further research will be needed to explain this curious neuroimaging finding, and to rule out cause for clinical concern.
脑深部电刺激（DBS）手术是治疗多种神经系统疾病的常用方法。然而，它并非没有潜在并发症，如出血和感染。有趣的是，我们在术后MRI上观察到几例DBS电极周围T2加权信号异常高强化的情况，这些情况与出血或感染无关。
为了更好地描述这一发现的发生率和时间，我们回顾性分析了一家机构9年来所有DBS植入患者的术后影像学资料。
在133例患者的239次植入手术中，术后MRI扫描发现15例DBS电极周围T2信号高强化（发生率6.3%）。信号特征最符合血管源性水肿，可能代表一种炎症反应。该发现通常为单侧，即使在同时植入双侧电极的患者中也是如此。大多数受影响患者无症状，尽管有3例有症状，1例出现明显步态不稳并接受了类固醇治疗。与术后立即进行的扫描相比，术后3天或更长时间进行的扫描中T2信号异常更为常见。有或无T2信号的患者在年龄、解剖靶点、诊断或微电极穿刺次数方面均无差异。需要进一步研究来解释这一奇怪的神经影像学发现，并排除临床担忧的原因。
