Functional Neurosurgery in the MRI Environment
| Autor: | De Salles Aa, Behnke E, Sinha S, Frighetto L, Frysinger R, Cynthia Cabatan-Awang, M. W. Y. Lee, R.C. Torres, Tseng L |
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| Rok vydání: | 2004 |
| Předmět: |
Adult
Male medicine.medical_specialty Deep brain stimulation Adolescent Image quality Interventional magnetic resonance imaging Deep Brain Stimulation medicine.medical_treatment Globus Pallidus Functional neurosurgery Lesion Subthalamic Nucleus Monitoring Intraoperative Tremor Humans Medicine Child Neuronavigation Aged Retrospective Studies Aged 80 and over Ventral Thalamic Nuclei Artifact (error) business.industry General Medicine Middle Aged Magnetic Resonance Imaging Surgery Microelectrode Child Preschool Feasibility Studies Female Neurology (clinical) Implant medicine.symptom business Nuclear medicine |
| Zdroj: | min - Minimally Invasive Neurosurgery. 47:284-289 |
| ISSN: | 1439-2291 0946-7211 |
| DOI: | 10.1055/s-2004-830094 |
| Popis: | Objective: The purpose of this study was to evaluate the feasibility of microelectrode recording, electrical stimulation, and electrode position checking during functional neurosurgical procedures (DBS, lesion) in the interventional magnetic resonance imaging (iMRI) environment. Methods: Seventy-six surgical procedures for DBS implant or radiofrequency lesion were performed in an open 0.2 T MRI operating room. DBS implants were performed in 54 patients (72 surgical procedures) and unilateral radiofrequency lesions in three for a total of 76 surgeries in 57 patients. Electrophysiological studies including macrostimulation and microelectrode recordings for localization were obtained in the 0.5 to 10 mT fringes of the magnetic field in 51 surgeries. MRI confirmation of the electrode position during the procedure was performed after electrophysiological localization. Results: The magnetic field associated with the MRI scanner did not contribute significant noise to microelectrode recordings. Anatomical confirmation of electrode position was possible within the MRI artifact from the DBS hardware. Symptomatic hemorrhage was detected in two (2.6%) patients during the operation. Image quality of the 0.2 T MRI scan was sub-optimal for anatomical localization. However, image fusion with preoperative scans permitted excellent visualization of the DBS electrode tip in relation to the higher quality 1.5 T MRI anatomical scans. Conclusion: This study shows that conventional stereotactic localization, microelectrode recordings, electrical stimulation, implant of DBS hardware, and radiofrequency lesion placement are possible in the open 0.2 T iMRI environment. The convenience of having an imaging modality that can visualize the brain during the operation is ideal for stereotactic procedures. |
| Databáze: | OpenAIRE |
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