Department of Neuroradiology, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Acta Neurochir (Wien). 2012 Nov;154(11):2051-62. doi: 10.1007/s00701-012-1476-0. Epub 2012 Aug 29.
Deep-brain stimulation (DBS) of the subthalamic nucleus (STN) is an accepted neurosurgical technique for the treatment of medication-resistant Parkinson's disease and other neurological disorders. The accurate targeting of the STN is facilitated by precise and reliable identification in pre-stereotactic magnetic resonance imaging (MRI). The aim of the study was to compare and evaluate different promising MRI methods at 7.0 T for the pre-stereotactic visualisation of the STN METHODS: MRI (T2-turbo spin-echo [TSE], T1-gradient echo [GRE], fast low-angle shot [FLASH] two-dimensional [2D] T2* and susceptibility-weighted imaging [SWI]) was performed in nine healthy volunteers. Delineation and image quality for the STN were independently evaluated by two neuroradiologists using a six-point grading system. Inter-rater reliability, contrast-to-noise ratios (CNRs) and signal-to-noise ratios (SNRs) for the STN were calculated. For the anatomical validation, the coronal FLASH 2D T2* images were co-registered with a stereotactic atlas (Schaltenbrand-Wahren).
The STN was clearly and reliably visualised in FLASH 2D T2* imaging (particularly coronal view), with a sharp delineation between the STN, the substantia nigra and the zona incerta. No major artefacts in the STN were observed in any of the sequences. FLASH 2D T2* and SWI images offered significantly higher CNR for the STN compared with T2-TSE. The co-registration of the coronal FLASH 2D T2* images with the stereotactic atlas affirmed the correct localisation of the STN in all cases.
The STN is best and reliably visualised in FLASH 2D T2* imaging (particularly coronal orientation) at 7.0-T MRI.
深部脑刺激（DBS）是治疗药物抵抗性帕金森病和其他神经疾病的一种被广泛接受的神经外科技术。通过在术前磁共振成像（MRI）中进行精确和可靠的识别，有助于准确靶向丘脑底核（STN）。本研究旨在比较和评估 7.0T 下不同有前途的 MRI 方法在 STN 术前可视化中的应用。
对 9 名健康志愿者进行 MRI（T2-涡轮自旋回波[TSE]、T1-梯度回波[GRE]、快速小角度激发[FLASH]二维[T2*]和磁化率加权成像[SWI]）。两名神经放射科医生使用六点分级系统对 STN 的描绘和图像质量进行独立评估。计算 STN 的组内信度、对比度噪声比（CNR）和信噪比（SNR）。为了进行解剖验证，将冠状面 FLASH 2D T2*图像与立体定向图谱（Schaltenbrand-Wahren）配准。
FLASH 2D T2成像（特别是冠状面）可清晰可靠地显示 STN，STN、黑质和间脑之间的边界清晰。在任何序列中都没有观察到 STN 的主要伪影。FLASH 2D T2和 SWI 图像提供的 STN CNR 明显高于 T2-TSE。冠状面 FLASH 2D T2*图像与立体定向图谱的配准证实了所有病例中 STN 的正确定位。
在 7.0T MRI 中，FLASH 2D T2*成像（特别是冠状面）最能可靠地显示 STN。
