Meng Ying, Huang Yuexi, Solomon Benjamin, Hynynen Kullervo, Scantlebury Nadia, Schwartz Michael L, Lipsman Nir
Division of Neurosurgery, Sunnybrook Health Sciences Centre.
Sunnybrook Research Institute, Sunnybrook Health Sciences Centre.
J Vis Exp. 2017 Dec 13(130):56365. doi: 10.3791/56365.
Essential tremor (ET) is the most common type of tremor in adults. While ET does not result in decreased life expectancy, the disabilities associated with ET can have a significant impact on quality of life, mood, functional activities, and socialization. Patients suffering from ET not sufficiently treated with first line medications may be eligible for alternative strategies such as deep brain stimulation, radiofrequency ablation, and MRI guided focused ultrasound (MRgFUS). High-intensity MRgFUS is an emerging modality to treat ET, its attraction for patients being that it is noninvasive and associated with short recovery time, as patients are home the day after treatment. While MRgFUS centers are still limited, it will become important for clinicians to consider MRgFUS as a treatment alternative, particularly in the case of a patient for whom open surgery is contraindicated. This article outlines the steps of patient selection, equipment setup, sonication, and post-treatment follow-up, as well as critical steps to be aware of when performing a MRgFUS procedure.
特发性震颤（ET）是成年人中最常见的震颤类型。虽然特发性震颤不会导致预期寿命缩短，但与特发性震颤相关的残疾会对生活质量、情绪、功能活动和社交产生重大影响。一线药物治疗效果不佳的特发性震颤患者可能有资格采用诸如深部脑刺激、射频消融和磁共振成像引导聚焦超声（MRgFUS）等替代策略。高强度MRgFUS是一种新兴的治疗特发性震颤的方法，它对患者的吸引力在于其无创性且恢复时间短，因为患者在治疗后第二天即可回家。虽然MRgFUS治疗中心仍然有限，但对于临床医生来说，将MRgFUS视为一种治疗选择变得很重要，特别是对于那些禁忌进行开放手术的患者。本文概述了患者选择、设备设置、超声治疗和治疗后随访的步骤，以及进行MRgFUS手术时需要注意的关键步骤。
