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聚焦超声在功能性神经外科手术中的应用

Focused ultrasound for functional neurosurgery.

作者信息

Lev-Tov Lior, Barbosa Daniel A N, Ghanouni Pejman, Halpern Casey H, Buch Vivek P

机构信息

Neurosurgery, Stanford University, Stanford, CA, USA.

Radiology, Stanford University, Stanford, CA, USA.

出版信息

J Neurooncol. 2022 Jan;156(1):17-22. doi: 10.1007/s11060-021-03818-3. Epub 2021 Aug 12.

Abstract

INTRODUCTION

Brain lesioning is a fundamental technique in the functional neurosurgery world. It has been investigated for decades and presented promising results long before novel pharmacological agents were introduced to treat movement disorders, psychiatric disorders, pain, and epilepsy. Ablative procedures were replaced by effective drugs during the 1950s and by Deep Brain Stimulation (DBS) in the 1990s as a reversible neuromodulation technique. In the last decade, however, the popularity of brain lesioning has increased again with the introduction of magnetic resonance-guided focused ultrasound (MRgFUS).

OBJECTIVE

In this review, we will cover the current and emerging role of MRgFUS in functional neurosurgery.

METHODS

Literature review from PubMed and compilation.

RESULTS

Investigated since 1930, MRgFUS is a technology enabling targeted energy delivery at the convergence of mechanical sound waves. Based on technological advancements in phased array ultrasound transducers, algorithms accounting for skull penetration by sound waves, and MR imaging for targeting and thermometry, MRgFUS is capable of brain lesioning with sub-millimeter precision and can be used in a variety of clinical indications.

CONCLUSION

MRgFUS is a promising technology evolving as a dominant tool in different functional neurosurgery procedures in movement disorders, psychiatric disorders, epilepsy, among others.

摘要

引言

脑毁损术是功能神经外科领域的一项基本技术。在新型药物被引入治疗运动障碍、精神障碍、疼痛和癫痫之前的几十年里,它就一直受到研究并取得了令人鼓舞的成果。在20世纪50年代,消融手术被有效的药物所取代,到了20世纪90年代,又被作为一种可逆性神经调节技术的深部脑刺激(DBS)所取代。然而,在过去十年中,随着磁共振引导聚焦超声(MRgFUS)的引入,脑毁损术的应用再度增多。

目的

在本综述中,我们将探讨MRgFUS在功能神经外科中的当前及新兴作用。

方法

对来自PubMed的文献进行综述并整理。

结果

自1930年起就开始研究的MRgFUS是一项能在机械声波汇聚处实现靶向能量传递的技术。基于相控阵超声换能器的技术进步、考虑声波穿透颅骨的算法以及用于靶向和温度测量的磁共振成像,MRgFUS能够以亚毫米级精度进行脑毁损,可用于多种临床适应症。

结论

MRgFUS是一项很有前景的技术,正逐渐成为运动障碍、精神障碍、癫痫等不同功能神经外科手术中的主要工具。

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