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基于磁共振成像导航的线圈磁场空间分布辅助临床医生精确操作重复经颅磁刺激的研究

Research on Assisting Clinicians to Operate rTMS Precisely Based on the Coil Magnetic Field Spatial Distribution With Magnetic Resonance Imaging Navigation.

作者信息

Li Shijun, Wang Yi, Li ShengJie, Lv Yanwei, Zhang Lei, Zou Jun, Ma Lin

机构信息

Department of Medical Instruments, Chinese People's Liberation Army General Hospital, Beijing, China.

Department of Radiology, Chinese People's Liberation Army General Hospital, Beijing, China.

出版信息

Front Neurosci. 2019 Aug 19;13:858. doi: 10.3389/fnins.2019.00858. eCollection 2019.

Abstract

To assist clinicians to operate repetitive Transcranial Magnetic Stimulation (rTMS) precisely based on the coil magnetic field spatial distribution with Magnetic Resonance Imaging (MRI) Navigation. A fast method for calculating electromagnetic fields in layered brain structures in frequency domain was proposed. By approaching Bessel function in different intervals, the integral with a highly oscillatory kernel was transformed into two parts: a definite integral and a weakened oscillatory one. The distribution of induced current density and magnetic field intensity of rTMS stimulation effect on brain was quantitatively calculated, so that clinicians could intuitively grasp the safe range of coil stimulation on the brain. Then, the crucial factor of the stimulation effect of rTMS was determined, and an accurate coil positioning of the rTMS efficiently was completed. The maximal attenuation of induced electric field and magnetic induction intensity was 72.20 and 86.867% at 3 cm away from the skin in the brain layered model. The clinical examination results of electric field intensity distribution, magnetic field intensity distribution, current density distribution, layered brain modeling, and coil location speed in the brain model teaching group were significantly higher than those in the traditional teaching group ( < 0.001). It is suitable for clinicians to quickly complete the precise positioning of rTMS, master the adjustment of coil stimulation therapeutic parameters, and realize the precise positioning operation of rTMS with MRI navigation in intracranial. Chinese Clinical Trial Registry (ChiCTR1800018616); Registered on 30th September 2018.

摘要

为协助临床医生基于磁共振成像(MRI)导航,根据线圈磁场空间分布精确操作重复经颅磁刺激(rTMS)。提出了一种在频域中计算分层脑结构中电磁场的快速方法。通过在不同区间逼近贝塞尔函数,将具有高度振荡核的积分转化为两部分:一个定积分和一个减弱振荡的积分。定量计算了rTMS刺激效应在脑内的感应电流密度和磁场强度分布,以便临床医生直观掌握线圈对脑刺激的安全范围。然后,确定了rTMS刺激效果的关键因素,并高效完成了rTMS的精确线圈定位。在脑分层模型中,距皮肤3 cm处感应电场和磁感应强度的最大衰减分别为72.20%和86.867%。脑模型教学组在电场强度分布、磁场强度分布、电流密度分布、分层脑建模及线圈定位速度等方面的临床考核结果均显著高于传统教学组(<0.001)。它适合临床医生快速完成rTMS的精确定位,掌握线圈刺激治疗参数的调整,并实现颅内MRI导航下rTMS的精确定位操作。中国临床试验注册中心(ChiCTR1800018616);于2018年9月30日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e540/6709653/a0284dbf71a2/fnins-13-00858-g0001.jpg

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