Neurosurgery Department, Shenzhen Children's Hospital, Shenzhen, China.
Neurosurgery Department, Shenzhen Children's Hospital, Shenzhen, China,
Stereotact Funct Neurosurg. 2020;98(2):73-79. doi: 10.1159/000505713. Epub 2020 Feb 7.
Stereoelectroencephalography (SEEG) refers to a commonly used diagnostic procedure to localise and define the epileptogenic zone of refractory focal epilepsies, by means of minimally invasive operation techniques without large craniotomies.
This study aimed to investigate the influence of different registration methods on the accuracy of SEEG electrode implantation under neuronavigation for paediatric patients with refractory epilepsy.
The clinical data of 18 paediatric patients with refractory epilepsy were retrospectively analysed. The SEEG electrodes were implanted under optical neuronavigation while the patients were in the prone position. Patients were divided into two groups on the basis of the surface-based registration of MR scan method and refined anatomy-based registration of CT scan. Registration time, accuracy, and the differences between electrode placement and preoperative planned position were analysed.
Thirty-six electrodes in 7 patients were placed under surface-based registration of MR scan, and 45 electrodes in 11 patients were placed under refined anatomy-based registration of CT scan. The registration time of surface-based registration of MR scan and refined anatomy-based registration of CT scan was 45 ± 12 min and 10 ± 4 min. In addition, the mean registration error, the error of insertion point, and target error were 3.6 ± 0.7 mm, 2.7 ± 0.7 mm, and 3.1 ± 0.5 mm in the surface-based registration of MR scan group, and 1.1 ± 0.3 mm, 1.5 ± 0.5 mm, and 2.2 ± 0.6 mm in the refined anatomy-based registration of CT scan group. The differences between the two registration methods were statistically significant.
The refined anatomy-based registration of CT scan method can improve the registration efficiency and electrode placement accuracy, and thereby can be considered as the preferred registration method in the application of SEEG electrode implantation under neuronavigation for treatment of paediatric intractable epilepsy.
立体脑电图（SEEG）是一种常用的诊断程序，通过微创操作技术而无需大的开颅手术，来定位和确定难治性局灶性癫痫的致痫区。
本研究旨在探讨不同配准方法对神经导航下儿童难治性癫痫患者立体脑电图（SEEG）电极植入准确性的影响。
回顾性分析 18 例儿童难治性癫痫患者的临床资料。患者在俯卧位下通过光学神经导航植入 SEEG 电极。根据磁共振（MR）扫描方法的基于表面的配准和 CT 扫描的精细解剖学配准，将患者分为两组。分析配准时间、准确性以及电极放置位置与术前计划位置之间的差异。
7 例患者在基于 MR 扫描的表面配准下植入 36 个电极，11 例患者在基于 CT 扫描的精细解剖学配准下植入 45 个电极。基于 MR 扫描的表面配准和基于 CT 扫描的精细解剖学配准的配准时间分别为 45±12 分钟和 10±4 分钟。此外，基于 MR 扫描的表面配准组的平均配准误差、插入点误差和目标误差分别为 3.6±0.7mm、2.7±0.7mm 和 3.1±0.5mm，基于 CT 扫描的精细解剖学配准组分别为 1.1±0.3mm、1.5±0.5mm 和 2.2±0.6mm。两种配准方法之间的差异具有统计学意义。
基于 CT 扫描的精细解剖学配准方法可以提高配准效率和电极放置准确性，因此可以考虑作为神经导航下治疗儿童难治性癫痫 SEGE 电极植入的首选配准方法。
