Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy.
Department of Physics and Chemistry, University of Palermo, Palermo, Italy.
Sci Rep. 2021 Jan 28;11(1):2524. doi: 10.1038/s41598-021-82271-8.
The prevalence and impact of imaging findings detected during screening procedures in patients undergoing transcranial MR-guided Focused Ultrasound (tcMRgFUS) thalamotomy for functional neurological disorders has not been assessed yet. This study included 90 patients who fully completed clinical and neuroradiological screenings for tcMRgFUS in a single-center. The presence and location of preoperative imaging findings that could impact the treatment were recorded and classified in three different groups according to their relevance for the eligibility and treatment planning. Furthermore, tcMRgFUS treatments were reviewed to evaluate the number of transducer elements turned off after marking as no pass regions the depicted imaging finding. A total of 146 preoperative imaging findings in 79 (87.8%) patients were detected in the screening population, with a significant correlation with patients' age (rho = 483, p < 0.001). With regard of the group classification, 119 (81.5%), 26 (17.8%) were classified as group 1 or 2, respectively. One patient had group 3 finding and was considered ineligible. No complications related to the preoperative imaging findings occurred in treated patients. Preoperative neuroradiological findings are frequent in candidates to tcMRgFUS and their identification may require the placement of additional no-pass regions to prevent harmful non-targeted heating.
在接受经颅磁共振引导聚焦超声（tcMRgFUS）丘脑切开术治疗功能性神经障碍的患者的筛查过程中，尚未评估检测到的影像学发现的患病率和影响。本研究纳入了在单中心接受完整的 tcMRgFUS 临床和神经影像学筛查的 90 例患者。记录并根据其对入选和治疗计划的相关性，将术前影像学发现的存在和位置分为三组进行分类，这些影像学发现可能会影响治疗。此外，还对 tcMRgFUS 治疗进行了评估，以评估在将所描绘的影像学发现标记为不通过区域后，关闭的换能器元件的数量。在筛查人群中，共检测到 79 例（87.8%）患者的 146 个术前影像学发现，与患者年龄呈显著相关性（rho=483，p<0.001）。在分组分类方面，分别有 119 例（81.5%）和 26 例（17.8%）患者分别归类为第 1 组或第 2 组。1 例患者存在第 3 组发现，被认为不适合治疗。在接受治疗的患者中，未发生与术前影像学发现相关的并发症。术前神经影像学发现常见于接受 tcMRgFUS 治疗的候选者，其识别可能需要放置额外的不通过区域，以防止有害的非靶向加热。
