Optimal MRI methods for direct stereotactic targeting of the subthalamic nucleus and globus pallidus
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Ruth L. O’Gorman, Karin Shmueli, Keyoumars Ashkan, Michael Samuel, David J. Lythgoe Asal Shahidiani, Stephen J. Wastling, Michelle Footman, Richard P
- چاپ و سال / کشور: 2010
Description
Objective Reliable identification of the subthalamic nucleus (STN) and globus pallidus interna (GPi) is critical for deep brain stimulation (DBS) of these structures. The purpose of this study was to compare the visibility of the STN and GPi with various MRI techniques and to assess the suitability of each technique for direct stereotactic targeting. Methods MR images were acquired from nine volunteers with T2- and proton density-weighted (PD-W) fast spin echo, susceptibility-weighted imaging (SWI), phase-sensitive inversion recovery and quantitative T1, T2 and T2* mapping sequences. Contrast-tonoise ratios (CNR) for the STN and GPi were calculated for all sequences. Targeting errors on SWI were evaluated on magnetic susceptibility maps. The sequences demonstrating the best conspicuity of DBS target structures (SWI and T2*) were then applied to ten patients with movement disorders, and the CNRs for these techniques were assessed. Results SWI offers the highest CNR for the STN, but standard PD-W images provide the best CNR for the pallidum. Susceptibility maps indicated that the GPi margins may be shifted slightly on SWI, although no shifts were seen for the STN. Conclusion SWI may improve the visibility of the STN on pre-operative MRI, potentially improving the accuracy of direct stereotactic targeting.
Eur Radiol (2011) 21: 130–136 DOI 10.1007/s00330-010-1885-5 Received: 18 March 2010 Revised: 11 May 2010 Accepted: 31 May 2010 Published online: 21 July 2010
