摘要/Abstract
摘要： 目的·探讨经脑深部电刺激（deep brain stimulation，DBS）治疗帕金森病（Parkinsons disease，PD）后，磁共振成像（magnetic resonance imaging，MRI）与计算机断层扫描（computed tomography，CT）对电极显示差异的潜在规律与成因分析，为优化临床决策提供参考。方法·选取2016年1月—2017年12月期间于上海交通大学医学院附属瑞金医院功能神经外科接受DBS治疗的PD患者49例，分别获取术后3～5 d的CT及3～6个月长期程控期间采集的MRI影像，比较短期CT联合术前MRI的融合影像、长期MRI影像对电极末端触点位置的显示差异。结果·共获取50组术后CT融合影像与术后MRI影像，右侧电极在2种影像显示的空间差距为1.36 （0.98，1.70） mm（P0.021），左侧电极的空间差距为1.28 （0.99，1.88） mm（P0.006）。双侧电极在术后长期与短期相比均存在向内侧、后方、底部与脑组织发生相对位移的趋势。结论·术后电极位移的潜在趋势能够为建立脑漂移模型并优化手术植入电极位置提供参考。
关键词: 帕金森病, 脑深部电刺激, 磁共振成像, 计算机断层扫描
Abstract:
Objective · To explore the potential regularity and caof the differences between magnetic resonance imaging (MRI) and computed tomography (CT) presenting electrodes after deep brain stimulation (DBS) for Parkinsons disease (PD), into provide reference for optimizing clinical decision. Methods · Forty-nine PD patients who underwent DBS treatment in Department of Functional Neurosurgery of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine Jan. 2016 to Dec. 2017 were selected. CT images were acquired 3-5 days after surgery and MRI images were acquired during 3-6 monthsthe follow-up of regular programming. The fused images of short-term CT combined with preoperative MRI and long-term MRI respectively were compared to show the differencethe tip contact positions of electrodes. Results · A total of 50 groups of postoperative CT fused images and MRI images were obtained. The space differences of the two types of images were 1.36 (0.98, 1.70) mm (P0.021) and 1.28 (0.99, 1.88) mm (P0.006), on the right and left electrodes, respectively. Bilateral electrodes in both short-term and long-term images had a tendency to move to the medial, rear, and bottom part of the brain. Conclusion · The potential tendency in shifts of DBS electrodes can provide reference for establishing the brain drift model and optimizing the position of the implanted electrode.
Key words: Parkinsons disease (PD), deep brain stimulation (DBS), magnetic resonance imaging (MRI), computed tomography (CT)
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