三维多模态成像在癫痫颅内电极植入中的应用价值
Utility of 3D multimodality imaging in the implantation of intracranial electrodes in epilepsy.
作者信息
Nowell Mark, Rodionov Roman, Zombori Gergely, Sparks Rachel, Winston Gavin, Kinghorn Jane, Diehl Beate, Wehner Tim, Miserocchi Anna, McEvoy Andrew W, Ourselin Sebastien, Duncan John
机构信息
Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, United Kingdom; Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom; MRI Unit, Epilepsy Society, Chalfont St Peter, United Kingdom.
出版信息
Epilepsia. 2015 Mar;56(3):403-13. doi: 10.1111/epi.12924. Epub 2015 Feb 5.
OBJECTIVE
We present a single-center prospective study, validating the use of 3D multimodality imaging (3 DMMI) in patients undergoing intracranial electroencephalography (IC-EEG).
METHODS
IC-EEG implantation preparation entails first designing of the overall strategy of implantation (strategy) and second the precise details of implantation (planning). For each case, the multidisciplinary team made decisions on strategy and planning before the disclosure of multimodal brain imaging models. Any changes to decisions, following disclosure of the multimodal models, were recorded.
RESULTS
Disclosure of 3 DMMI led to a change in strategy in 15 (34%) of 44 individuals. The changes included addition and subtraction of electrodes, addition of grids, and going directly to resection. For the detailed surgical planning, 3 DMMI led to a change in 35 (81%) of 43 individuals. Twenty-five (100%) of 25 patients undergoing stereo-EEG (SEEG) underwent a change in electrode placement, with 158 (75%) of 212 electrode trajectories being altered.
SIGNIFICANCE
The use of 3 DMMI makes substantial changes in clinical decision making.
目的
我们开展了一项单中心前瞻性研究，以验证三维多模态成像（3DMMI）在接受颅内脑电图（IC-EEG）检查患者中的应用。
方法
IC-EEG植入准备首先需要设计植入的总体策略（策略），其次是植入的精确细节（规划）。对于每个病例，多学科团队在多模态脑成像模型披露之前就策略和规划做出决策。在多模态模型披露之后，记录决策的任何变化。
结果
44例患者中有15例（34%）在披露3DMMI后策略发生了变化。这些变化包括电极的增减、网格的添加以及直接进行切除术。对于详细的手术规划，43例患者中有35例（81%）在披露3DMMI后规划发生了变化。25例接受立体脑电图（SEEG）检查的患者中有25例（100%）电极放置发生了变化，212条电极轨迹中有158条（75%）发生了改变。
意义
3DMMI的使用在临床决策中产生了重大变化。
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