Southwell Derek G, Narvid Jared A, Martin Alastair J, Qasim Salman E, Starr Philip A, Larson Paul S
Department of Neurological Surgery, University of California, San Francisco, Calif., USA.
Stereotact Funct Neurosurg. 2016;94(2):102-7. doi: 10.1159/000443407. Epub 2016 Apr 20.
Interventional magnetic resonance imaging (iMRI) allows deep brain stimulator lead placement under general anesthesia. While the accuracy of lead targeting has been described for iMRI systems utilizing 1.5-tesla magnets, a similar assessment of 3-tesla iMRI procedures has not been performed.
To compare targeting accuracy, the number of lead targeting attempts, and surgical duration between procedures performed on 1.5- and 3-tesla iMRI systems.
Radial targeting error, the number of targeting attempts, and procedure duration were compared between surgeries performed on 1.5- and 3-tesla iMRI systems (SmartFrame and ClearPoint systems).
During the first year of operation of each system, 26 consecutive leads were implanted using the 1.5-tesla system, and 23 consecutive leads were implanted using the 3-tesla system. There was no significant difference in radial error (Mann-Whitney test, p = 0.26), number of lead placements that required multiple targeting attempts (Fisher's exact test, p = 0.59), or bilateral procedure durations between surgeries performed with the two systems (p = 0.15).
Accurate DBS lead targeting can be achieved with iMRI systems utilizing either 1.5- or 3-tesla magnets. The use of a 3-tesla magnet, however, offers improved visualization of the target structures and allows comparable accuracy and efficiency of placement at the selected targets.
介入式磁共振成像(iMRI)可在全身麻醉下进行脑深部刺激器电极植入。虽然已报道了使用1.5特斯拉磁体的iMRI系统电极靶向的准确性,但尚未对3特斯拉iMRI手术进行类似评估。
比较在1.5特斯拉和3特斯拉iMRI系统上进行的手术之间的靶向准确性、电极靶向尝试次数和手术持续时间。
比较在1.5特斯拉和3特斯拉iMRI系统(SmartFrame和ClearPoint系统)上进行的手术之间的径向靶向误差、靶向尝试次数和手术持续时间。
在每个系统运行的第一年,使用1.5特斯拉系统连续植入26根电极,使用3特斯拉系统连续植入23根电极。两个系统进行的手术之间,径向误差(曼-惠特尼检验,p = 0.26)、需要多次靶向尝试的电极植入次数(费舍尔精确检验,p = 0.59)或双侧手术持续时间均无显著差异(p = 0.15)。
使用1.5特斯拉或3特斯拉磁体的iMRI系统均可实现准确的脑深部刺激器电极靶向。然而,使用3特斯拉磁体可改善目标结构的可视化,并在选定目标处实现相当的放置准确性和效率。