Medical Faculty Mannheim, Department of Neuroradiology, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, Mannheim, Germany.
Acta Neurochir (Wien). 2012 Mar;154(3):481-94. doi: 10.1007/s00701-011-1242-8. Epub 2011 Dec 14.
Deep-brain stimulation (DBS) of the internal globus pallidus (GPi) has shown remarkable therapeutic benefits for treatment-resistant neurological disorders including dystonia and Parkinson's disease (PD). The success of the DBS is critically dependent on the reliable visualization of the GPi. The aim of the study was to evaluate promising 3.0 Tesla magnetic resonance imaging (MRI) methods for pre-stereotactic visualization of the GPi using a standard installation protocol.
MRI at 3.0 T of nine healthy individuals and of one patient with PD was acquired (FLAIR, T1-MPRAGE, T2-SPACE, T2*-FLASH2D, susceptibility-weighted imaging mapping (SWI)). Image quality and visualization of the GPi for each sequence were assessed by two neuroradiologists independently using a 6-point scale. Axial, coronal, and sagittal planes of the T2*-FLASH2D images were compared. Inter-rater reliability, contrast-to-noise ratios (CNR) and signal-to-noise ratios (SNR) for the GPi were determined. For illustration, axial T2*-FLASH2D images were fused with a section schema of the Schaltenbrand-Wahren stereotactic atlas.
The GPi was best and reliably visualized in axial and to a lesser degree on coronal T2*-FLASH2D images. No major artifacts in the GPi were observed in any of the sequences. SWI offered a significantly higher CNR for the GPi compared to standard T2-weighted imaging using the standard parameters. The fusion of the axial T2*-FLASH2D images and the atlas projected the GPi clearly in the boundaries of the section schema.
Using a standard installation protocol at 3.0 T T2*-FLASH2D imaging (particularly axial view) provides optimal and reliable delineation of the GPi.
深部脑刺激（DBS）内侧苍白球（GPi）已显示出对包括肌张力障碍和帕金森病（PD）在内的治疗抵抗性神经疾病的显著治疗益处。DBS 的成功高度依赖于 GPi 的可靠可视化。本研究的目的是评估有前途的 3.0T 磁共振成像（MRI）方法，以使用标准安装方案对 GPi 进行术前可视化。
对 9 名健康个体和 1 名 PD 患者进行 3.0T MRI 采集（FLAIR、T1-MPRAGE、T2-SPACE、T2*-FLASH2D、磁化率加权成像图（SWI））。两位神经放射科医生独立使用 6 分制评估每个序列的图像质量和 GPi 可视化。比较 T2*-FLASH2D 图像的轴位、冠状位和矢状位。确定 GPi 的组内相关系数（ICC）、对比噪声比（CNR）和信噪比（SNR）。为了说明问题，将轴向 T2*-FLASH2D 图像与 Schaltenbrand-Wahren 立体定向图谱的一个截面图融合。
GPi 在轴向和一定程度上的冠状位 T2*-FLASH2D 图像上显示最佳且可靠。在任何序列中，GPi 均未观察到明显的伪影。与使用标准参数的标准 T2 加权成像相比，SWI 为 GPi 提供了显著更高的 CNR。轴向 T2*-FLASH2D 图像与图谱的融合清晰地将 GPi 投射到截面图的边界内。
在 3.0T 下使用标准安装方案进行 T2*-FLASH2D 成像（特别是轴位视图）可提供 GPi 的最佳和可靠描绘。
