Wang Xin, Li Nan, Li Jiaming, Kou Huijuan, Wang Jing, Jing Jiangpeng, Su Mingming, Li Yang, Qu Liang, Wang Xuelian
Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an 710038, China.
Department of Cardiology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710004, China.
Brain Sci. 2022 Jul 22;12(8):967. doi: 10.3390/brainsci12080967.
Co-registration of stereotactic and preoperative magnetic resonance imaging (MRI) images can serve as an alternative for trajectory planning. However, the role of this strategy has not yet been proven by any control studies, and the trajectories of commonly used targets have not been systematically studied. The purpose of this study was to analyze the trajectories for various targets, and to assess the role of trajectories realized on fused images in preventing intracranial hemorrhage (ICH). Data from 1019 patients who underwent electrode placement for deep brain stimulation were acquired. Electrode trajectories were not planned for 396 patients, whereas trajectories were planned for 623 patients. Preoperative various MRI sequences and frame-placed MRI images were fused for trajectory planning. The patients’ clinical characteristics, the stereotactic systems, intracranial hemorrhage cases, and trajectory angles were recorded and analyzed. No statistically significant differences in the proportions of male patients, patients receiving local anesthesia, and diseases or target distributions (p > 0.05) were found between the trajectory planning group and the non-trajectory planning group, but statistically significant differences were observed in the numbers of both patients and leads associated with symptomatic ICH (p < 0.05). Regarding the ring and arc angle values, statistically significant differences were found among various target groups (p < 0.05). The anatomic structures through which leads passed were found to be diverse. Trajectory planning based on MRI fusion is a safe technique for lead placement. The electrode for each given target has its own relatively constant trajectory.
立体定向与术前磁共振成像（MRI）图像的联合配准可作为轨迹规划的一种替代方法。然而，这一策略的作用尚未得到任何对照研究的证实，且常用靶点的轨迹也未得到系统研究。本研究的目的是分析不同靶点的轨迹，并评估在融合图像上实现的轨迹在预防颅内出血（ICH）中的作用。收集了1019例行深部脑刺激电极植入患者的数据。396例患者未规划电极轨迹，而623例患者规划了轨迹。术前将各种MRI序列与放置框架后的MRI图像进行融合以进行轨迹规划。记录并分析患者的临床特征、立体定向系统、颅内出血病例及轨迹角度。轨迹规划组与非轨迹规划组在男性患者比例、接受局部麻醉的患者比例以及疾病或靶点分布方面未发现统计学显著差异（p>0.05），但在有症状ICH相关的患者和导联数量上观察到统计学显著差异（p<0.05）。关于环和弧角度值，不同靶点组之间存在统计学显著差异（p<0.05）。发现导联穿过的解剖结构各不相同。基于MRI融合的轨迹规划是一种安全的导联植入技术。每个给定靶点的电极都有其相对恒定的轨迹。
