Sammartino Francesco, Hodaie Mojgan
Prog Neurol Surg. 2018;33:62-79. doi: 10.1159/000480766. Epub 2018 Jan 12.
Since its introduction, diffusion tensor imaging (DTI) has become an important tool in neuroscience given its unprecedented ability to image brain white matter in vivo. The interest in understanding the mechanisms of action of Deep Brain Stimulation in different targets and indications, together with the constant drive towards the improvement in long-term clinical outcomes, has found a logical complement in the application of tractography in this field. Diffusion tensor imaging has been traditionally associated with an increased susceptibility to MRI artifacts, and expensive computational resources. Recent advances have however improved these restrictions, allowing for countless applications in Neurosurgery, as demonstrated by the large number of original research papers published in the last decade. In this chapter, we review the current status of the implementation of DTI during DBS of the basal ganglia, discussing the findings, potential challenges and the expected improvements in surgical outcomes deriving by the routine use of tractography in functional neurosurgery.
自引入以来，扩散张量成像（DTI）凭借其在体内对脑白质成像的前所未有的能力，已成为神经科学中的一项重要工具。对理解不同靶点和适应症的深部脑刺激作用机制的兴趣，以及对改善长期临床结果的持续推动，在该领域的纤维束成像应用中找到了合理的补充。传统上，扩散张量成像与对MRI伪影的易感性增加以及昂贵的计算资源相关联。然而，最近的进展改善了这些限制，使得在神经外科中有无数应用，过去十年发表的大量原创研究论文就证明了这一点。在本章中，我们回顾了在基底神经节的深部脑刺激过程中扩散张量成像的应用现状，讨论了研究结果、潜在挑战以及通过在功能神经外科中常规使用纤维束成像而在手术结果方面预期的改善。
