Meneses M S, Arruda W O, Hunhevicz S C, Ramina R, Pedrozo A A, Tsubouchi M H
Department of Neurosurgery, Hospital das Nações, Curitiba, PR, Brazil.
Arq Neuropsiquiatr. 1997 Sep;55(3B):547-52. doi: 10.1590/s0004-282x1997000400005.
Stereotactic surgery for Parkinson's disease can be performed using different neuroimaging methods. Ventriculography has been used to locate the coordinates of the structures close to the third ventricle. Although it has several potential disadvantages related to the intraventricular injection of iodine contrast, it is considered a precise method. Computed tomography and magnetic resonance imaging have been used in some centers. In order to compare their efficacy, 50 stereotactic thalamotomies for Parkinson's disease were performed using either ventriculography (VE) (25) or magnetic resonance imaging (MRI) (25). In 14 out of 25 VE procedures, computed tomography (CT-scan) was also used and showed a significant mean difference of coordinate Y and Z. The clinical results employing either VE or MRI were similar, with 80% abolition of tremor in the VE group, and 84% in the MRI group, after a follow up period of at least 3 months. Another 12% of VE and 16% of MRI group showed significant improvement of tremor. Complication rate was 4% in both groups. MRI-guided stereotactic thalamotomy in Parkinson's disease has shown good clinical results, comparable to VE-guided stereotaxis.
帕金森病的立体定向手术可使用不同的神经成像方法来进行。脑室造影术已被用于确定靠近第三脑室的结构的坐标。尽管它存在与脑室内注射碘造影剂相关的若干潜在缺点，但它仍被视为一种精确的方法。计算机断层扫描和磁共振成像已在一些中心得到应用。为了比较它们的疗效，对50例帕金森病患者进行了立体定向丘脑切开术，其中25例使用脑室造影术（VE），25例使用磁共振成像（MRI）。在25例VE手术中的14例中，还使用了计算机断层扫描（CT扫描），结果显示坐标Y和Z存在显著的平均差异。采用VE或MRI的临床结果相似，在至少3个月的随访期后，VE组震颤消失率为80%，MRI组为84%。VE组另外12%以及MRI组16%的患者震颤有显著改善。两组的并发症发生率均为4%。帕金森病的MRI引导立体定向丘脑切开术已显示出良好的临床效果，与VE引导的立体定向术相当。
