Sillay Karl A, Rusy Deborah, Buyan-Dent Laura, Ninman Nancy L, Vigen Karl K
University of Wisconsin, Department of Neurosurgery and Biomedical Engineering, Madison, WI, USA; Semmes-Murphey Clinic, Memphis, TN, USA; University of Tennessee Department of Neurosurgery, Memphis, TN, USA; University of Tennessee Department of Electrical Engineering and Computer Science, Knoxville, TN, USA.
University of Wisconsin, Department of Anesthesiology, Madison, WI, USA.
Clin Neurol Neurosurg. 2014 Dec;127:79-85. doi: 10.1016/j.clineuro.2014.09.017. Epub 2014 Oct 2.
We report results of the initial experience with magnetic resonance image (MRI)-guided implantation of subthalamic nucleus (STN) deep brain stimulating (DBS) electrodes at the University of Wisconsin after having employed frame-based stereotaxy with previously available MR imaging techniques and microelectrode recording for STN DBS surgeries.
Ten patients underwent MRI-guided DBS implantation of 20 electrodes between April 2011 and March 2013. The procedure was performed in a purpose-built intraoperative MRI suite configured specifically to allow MRI-guided DBS, using a wide-bore (70 cm) MRI system. Trajectory guidance was accomplished with commercially available system consisting of an MR-visible skull-mounted aiming device and a software guidance system processing intraoperatively acquired iterative MRI scans.
A total of 10 patients (5 male, 5 female)-representative of the Parkinson Disease (PD) population-were operated on with standard technique and underwent 20 electrode placements under MRI-guided bilateral STN-targeted DBS placement. All patients completed the procedure with electrodes successfully placed in the STN. Procedure time improved with experience.
Our initial experience confirms the safety of MRI-guided DBS, setting the stage for future investigations combining physiology and MRI guidance. Further follow-up is required to compare the efficacy of the MRI-guided surgery cohort to that of traditional frame-based stereotaxy.
我们报告了威斯康星大学在使用基于框架的立体定向技术以及先前可用的磁共振成像技术和微电极记录进行丘脑底核（STN）深部脑刺激（DBS）手术之后，首次进行磁共振成像（MRI）引导下STN深部脑刺激电极植入的经验结果。
2011年4月至2013年3月期间，10例患者接受了MRI引导下的20个电极的DBS植入手术。该手术在专门配置的术中MRI套件中进行，该套件特别设计用于允许MRI引导的DBS，使用宽孔径（70厘米）的MRI系统。轨迹引导通过市售系统完成，该系统由一个MR可见的安装在颅骨上的瞄准装置和一个处理术中获取的迭代MRI扫描的软件引导系统组成。
共有10例患者（5男，5女）——代表帕金森病（PD）人群——接受了标准技术手术，并在MRI引导下进行了双侧STN靶向DBS植入，共放置了20个电极。所有患者均成功完成手术，电极成功植入STN。随着经验的积累，手术时间有所缩短。
我们的初步经验证实了MRI引导下DBS的安全性，为未来结合生理学和MRI引导的研究奠定了基础。需要进一步随访以比较MRI引导手术组与传统基于框架的立体定向手术组的疗效。
