Gagliardo Cesare, Cannella Roberto, D'Angelo Costanza, Toia Patrizia, Salvaggio Giuseppe, Feraco Paola, Marrale Maurizio, Iacopino Domenico Gerardo, D'Amelio Marco, La Tona Giuseppe, La Grutta Ludovico, Midiri Massimo
Section of Radiological Sciences, Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy.
Neuroradiology Unit, S. Chiara Hospital, 38122 Trento, Italy.
Brain Sci. 2021 Jan 4;11(1):46. doi: 10.3390/brainsci11010046.
High-quality intraoperative imaging is needed for optimal monitoring of patients undergoing transcranial MR-guided Focused Ultrasound (tcMRgFUS) thalamotomy. In this paper, we compare the intraoperative imaging obtained with dedicated FUS-Head coil and standard body radiofrequency coil in tcMRgFUS thalamotomy using 1.5-T MR scanner.
This prospective study included adult patients undergoing tcMRgFUS for treatment of essential tremor. Intraoperative T2-weighted FRFSE sequences were acquired after the last high-energy sonication using a dedicated two-channel FUS-Head (2ch-FUS) coil and body radiofrequency (body-RF) coil. Postoperative follow-ups were performed at 48 h using an eight-channel phased-array (8ch-HEAD) coil. Two readers independently assessed the signal-to-noise ratio (SNR) and evaluated the presence of concentric lesional zones (zone I, II and III). Intraindividual differences in SNR and lesional findings were compared using the Wilcoxon signed rank sum test and McNemar test.
Eight patients underwent tcMRgFUS thalamotomy. Intraoperative T2-weighted FRFSE images acquired using the 2ch-FUS coil demonstrated significantly higher SNR (R1 median SNR: 10.54; R2: 9.52) compared to the body-RF coil (R1: 2.96, < 0.001; R2: 2.99, < 0.001). The SNR was lower compared to the 48-h follow-up ( < 0.001 for both readers). Intraoperative zone I and zone II were more commonly visualized using the 2ch-FUS coil (R1, = 0.031 and = 0.008, R2, = 0.016, = 0.008), without significant differences with 48-h follow-up ( ≥ 0.063). The inter-reader agreement was almost perfect for both SNR (ICC: 0.85) and lesional findings (: 0.82-0.91).
In the study population, the dedicated 2ch-FUS coil significantly improved the SNR and visualization of lesional zones on intraoperative imaging during tcMRgFUS performed with a 1.5-T MR scanner.
对于接受经颅磁共振引导聚焦超声（tcMRgFUS）丘脑切开术的患者，需要高质量的术中成像以进行最佳监测。在本文中，我们比较了在使用1.5-T磁共振扫描仪进行的tcMRgFUS丘脑切开术中，使用专用的聚焦超声头部线圈和标准体部射频线圈获得的术中成像。
这项前瞻性研究纳入了接受tcMRgFUS治疗特发性震颤的成年患者。在最后一次高能超声治疗后，使用专用的双通道聚焦超声头部（2ch-FUS）线圈和体部射频（body-RF）线圈采集术中T2加权快速恢复快速自旋回波序列。术后48小时使用八通道相控阵（8ch-HEAD）线圈进行随访。两名阅片者独立评估信噪比（SNR）并评估同心病变区域（I区、II区和III区）的存在情况。使用Wilcoxon符号秩和检验和McNemar检验比较信噪比和病变表现的个体内差异。
8例患者接受了tcMRgFUS丘脑切开术。与体部射频线圈相比，使用2ch-FUS线圈采集的术中T2加权快速恢复快速自旋回波图像显示出显著更高的信噪比（R1中位数信噪比：10.54；R2：9.52）（R1：2.96，<0.001；R2：2.99，<0.001）。与48小时随访相比，信噪比更低（两位阅片者均<0.001）。使用2ch-FUS线圈更常观察到术中I区和II区（R1，P = 0.031和P = 0.008，R2，P = 0.016，P = 0.008），与48小时随访无显著差异（P≥0.063）。阅片者间对于信噪比（ICC：0.85）和病变表现（κ：从0.82至0.91）的一致性几乎完美。
在研究人群中，在使用1.5-T磁共振扫描仪进行的tcMRgFUS术中成像期间，专用的2ch-FUS线圈显著提高了信噪比和病变区域的可视化程度。
