Moens Maarten, Droogmans Steven, Spapen Herbert, De Smedt Ann, Brouns Raf, Van Schuerbeek Peter, Luypaert Robert, Poelaert Jan, Nuttin Bart
Department of Neurosurgery, Center for Neurosciences, UZ Brussel, Brussels, Belgium.
Clin Neurol Neurosurg. 2012 Feb;114(2):135-41. doi: 10.1016/j.clineuro.2011.09.013. Epub 2011 Oct 22.
Spinal cord stimulation (SCS) is a well-known treatment option for intractable neuropathic pain after spinal surgery, but its pathophysiological mechanisms are poorly stated. The goal of this study is to analyse the feasibility of using brain MRI, functional MRI (fMRI) and Magnetic Resonance Spectroscopy (MRS) as tools to analyse these mechanisms in patients with externalised neurostimulators during trial period.
The authors conducted in an in vitro and in vivo study analysing safety issues when performing brain MRI, fMRI and MRS investigations in human subjects with externalised SCS. Temperature measurements in vitro were performed simulating SCS during MRI sequences using head transmit-receive coils in 1.5 and 3 T MRI systems. 40 Patients with externalised SCS were included in the in vivo study. 20 patients underwent brain MRI, fMRI and another 20 patients underwent brain MRI and MRS.
A maximal temperature increase of 0.2°C was measured and neither electrode displacements nor hardware failures were observed. None of the patients undergoing the MRS sequences at the 1.5 or 3 T MRI scanners described any discomfort or unusual sensations.
We can conclude that brain MRI, fMRI and MRS studies performed in patients with externalised SCS can be safely executed.
脊髓刺激（SCS）是脊柱手术后顽固性神经性疼痛的一种知名治疗选择，但其病理生理机制尚不明确。本研究的目的是分析在试验期使用脑磁共振成像（MRI）、功能磁共振成像（fMRI）和磁共振波谱（MRS）作为工具来分析外置神经刺激器患者这些机制的可行性。
作者进行了一项体外和体内研究，分析在患有外置SCS的人体受试者中进行脑MRI、fMRI和MRS检查时的安全性问题。在1.5T和3T MRI系统中使用头部发射-接收线圈，在MRI序列期间模拟SCS进行体外温度测量。40例患有外置SCS的患者被纳入体内研究。20例患者接受了脑MRI、fMRI检查，另外20例患者接受了脑MRI和MRS检查。
测量到最大温度升高0.2°C，未观察到电极移位或硬件故障。在1.5T或3T MRI扫描仪上接受MRS序列检查的患者均未描述任何不适或异常感觉。
我们可以得出结论，对患有外置SCS的患者进行脑MRI、fMRI和MRS研究可以安全地进行。
