Li Jun, Li Yufei, Gutierrez Lorenzo, Xu Wenying, Wu Yiwen, Liu Chunlei, Li Dianyou, Sun Bomin, Zhang Chencheng, Wei Hongjiang
Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.
Front Hum Neurosci. 2020 Jan 9;13:447. doi: 10.3389/fnhum.2019.00447. eCollection 2019.
The centromedian (CM) nucleus is an intralaminar thalamic nucleus that is considered as a potentially effective target of deep brain stimulation (DBS) and ablative surgeries for the treatment of multiple neurological and psychiatric disorders. However, the structure of CM is invisible on the standard T1- and T2-weighted (T1w and T2w) magnetic resonance images, which hamper it as a direct DBS target for clinical applications. The purpose of the current study is to demonstrate the use of quantitative susceptibility mapping (QSM) technique to image the CM within the thalamic region. Twelve patients with Parkinson's disease, dystonia, or schizophrenia were included in this study. A 3D multi-echo gradient recalled echo (GRE) sequence was acquired together with T1w and T2w images on a 3-T MR scanner. The QSM image was reconstructed from the GRE phase data. Direct visual inspection of the CM was made on T1w, T2w, and QSM images. Furthermore, the contrast-to-noise ratios (CNRs) of the CM to the adjacent posterior part of thalamus on T1w, T2w, and QSM images were compared using the one-way analysis of variance (ANOVA) test. QSM dramatically improved the visualization of the CM nucleus. Clear delineation of CM compared to the surroundings was observed on QSM but not on T1w and T2w images. Statistical analysis showed that the CNR on QSM was significantly higher than those on T1w and T2w images. Taken together, our results indicate that QSM is a promising technique for improving the visualization of CM as a direct targeting for DBS surgery.
中央中核（CM）是丘脑板内核，被认为是深部脑刺激（DBS）和切除手术治疗多种神经和精神疾病的潜在有效靶点。然而，在标准的T1加权和T2加权（T1w和T2w）磁共振图像上，CM的结构不可见，这阻碍了它作为临床应用中直接的DBS靶点。本研究的目的是证明使用定量磁化率成像（QSM）技术对丘脑区域内的CM进行成像。本研究纳入了12例帕金森病、肌张力障碍或精神分裂症患者。在3-T磁共振扫描仪上，采集了3D多回波梯度回波（GRE）序列以及T1w和T2w图像。从GRE相位数据重建QSM图像。在T1w、T2w和QSM图像上直接目视检查CM。此外，使用单因素方差分析（ANOVA）检验比较了T1w、T2w和QSM图像上CM与丘脑相邻后部的对比噪声比（CNR）。QSM显著改善了CM核的可视化。在QSM图像上观察到CM与周围环境相比有清晰的轮廓，而在T1w和T2w图像上则没有。统计分析表明，QSM上的CNR显著高于T1w和T2w图像上的CNR。综上所述，我们的结果表明，QSM是一种有前景的技术，可改善CM作为DBS手术直接靶点的可视化。
