Barnaure I, Pollak P, Momjian S, Horvath J, Lovblad K O, Boëx C, Remuinan J, Burkhard P, Vargas M I
Department of Neuroradiology, Geneva University Hospital, Gabrielle Perret Gentil, 4, 1211, Geneva 14, Switzerland.
Department of Neurology, Geneva University Hospital, Geneva, Switzerland.
Neuroradiology. 2015 Sep;57(9):903-8. doi: 10.1007/s00234-015-1547-z. Epub 2015 May 29.
Imaging has an essential role in the evaluation of correct positioning of electrodes implanted for deep brain stimulation (DBS). Although MRI offers superior anatomic visualization of target sites, there are safety concerns in patients with implanted material; imaging guidelines are inconsistent and vary. The fusion of postoperative CT with preoperative MRI images can be an alternative for the assessment of electrode positioning. The purpose of this study was to assess the accuracy of measurements realized on fused images (acquired without a stereotactic frame) using a manufacturer-provided software.
Data from 23 Parkinson's disease patients who underwent bilateral electrode placement for subthalamic nucleus (STN) DBS were acquired. Preoperative high-resolution T2-weighted sequences at 3 T, and postoperative CT series were fused using a commercially available software. Electrode tip position was measured on the obtained images in three directions (in relation to the midline, the AC-PC line and an AC-PC line orthogonal, respectively) and assessed in relation to measures realized on postoperative 3D T1 images acquired at 1.5 T.
Mean differences between measures carried out on fused images and on postoperative MRI lay between 0.17 and 0.97 mm.
Fusion of CT and MRI images provides a safe and fast technique for postoperative assessment of electrode position in DBS.
成像在评估用于深部脑刺激（DBS）的植入电极的正确定位中起着至关重要的作用。尽管MRI能提供靶位点卓越的解剖可视化，但对于植入材料的患者存在安全问题；成像指南并不一致且各不相同。术后CT与术前MRI图像的融合可作为评估电极定位的一种替代方法。本研究的目的是使用制造商提供的软件评估在融合图像（无立体定向框架获取）上进行测量的准确性。
获取了23例接受双侧丘脑底核（STN）DBS电极植入的帕金森病患者的数据。使用市售软件将术前3T高分辨率T2加权序列和术后CT系列进行融合。在获得的图像上沿三个方向（分别相对于中线、AC-PC线和与AC-PC线正交的线）测量电极尖端位置，并与在1.5T获取的术后3D T1图像上进行的测量结果进行评估比较。
在融合图像和术后MRI上进行的测量之间的平均差异在0.17至0.97毫米之间。
CT和MRI图像的融合为DBS术后电极位置评估提供了一种安全、快速的技术。
