帕金森病中非增强成像引导的脑深部刺激电极植入的安全性
Safety of Noncontrast Imaging-Guided Deep Brain Stimulation Electrode Placement in Parkinson Disease.
作者信息
Cordeiro Joacir Graciolli, Diaz Anthony, Davis Jenna Kylene, Di Luca Daniel Garbin, Farooq Ghulam, Luca Corneliu C, Jagid Jonathan Russell
机构信息
Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA.
出版信息
World Neurosurg. 2020 Feb;134:e1008-e1014. doi: 10.1016/j.wneu.2019.11.071. Epub 2019 Nov 19.
BACKGROUND
Deep brain stimulation (DBS) is considered standard of care for the treatment of medically refractory Parkinson disease (PD). The placement of brain electrodes is performed using contrast imaging to enhance blood vessel identification during stereotactic planning. We present our experience with a series of patients implanted using noncontrast imaging.
METHODS
All cases of DBS surgery for PD performed between 2012 and 2018 with noncontrast imaging were retrospectively reviewed. Clinical features, postoperative imaging, and complications were analyzed.
RESULTS
A total of 287 deep-seated electrodes were implanted in 152 patients. Leads were placed at the subthalamic nucleus and globus pallidus internus in 258 and 29 hemispheres, respectively. We identified 2 cases of intracranial hemorrhage (0.7%).
CONCLUSIONS
DBS lead placement can be performed without the use of intravenous contrast with a postoperative intracranial hemorrhage rate comparable with other reported series.
背景
脑深部电刺激术（DBS）被认为是治疗药物难治性帕金森病（PD）的标准治疗方法。在立体定向规划过程中，使用对比成像来放置脑电极以增强血管识别。我们介绍了一系列使用非对比成像进行植入的患者的经验。
方法
回顾性分析2012年至2018年间使用非对比成像进行的所有PD患者DBS手术病例。分析临床特征、术后影像学表现及并发症。
结果
152例患者共植入287个深部电极。分别在258个和29个半球的丘脑底核和苍白球内侧部放置电极。我们发现2例颅内出血（0.7%）。
结论
DBS电极植入可以在不使用静脉造影剂的情况下进行，术后颅内出血率与其他报道系列相当。
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