微电极记录技术手术治疗帕金森病的CT影像学评价  

CT imaging evaluation of microelectrode electrophysiological recording in operation for Parkinson's disease.

作　　者：谢明国[1] 刘文斌[1] 李映凡[1] 侯键[1] 余朝骏[1] 

机构地区：[1]成都中医药大学临床医学院,四川成都610072

出　　处：《四川医学》2002年第6期564-566,共3页Sichuan Medical Journal

摘　　要：目的　评价帕金森病 (PD)在微电极导向下行丘脑腹外侧核 (Vim核 )和苍白球腹后部 (PVP核 )毁损术的CT影像学定位作用及术后 CT表现。方法　术前对 1 80例 PD患者行 CT定位 ,并与术中微电极记录电生理定位靶点对比分析。术后 2 4小时内 CT复查。 1 0例 6～ 8月内 CT复查。结果　 1 CT定位靶点吻合率为 34% ,更正率为 66% ,更正范围为 2± 1 .5mm。 2术后靶点毁损灶及周围水肿 CT表现为边缘模糊的低密度区 ,其范围波及内囊区 (1 0 0 % )或 /和视束 (2 5% ) ,平均大小分别为 :单靶点毁损为 486± 1 0 8mm3 ,双靶点毁损为 977± 2 34mm3。1 0例术后 6～ 8个月 CT复查 ,毁损灶大小为 2 9.5± 1 9.8mm3 。 3术后并发症 :毁损灶出血 1 0例 ,针道出血 4例。结论　影像学定位是手术成功及减少并发症的关键。术后 CT表现对了解和评价术后情况及指导临床治疗具有重要意义。Objective To evaluate the localization and postoperative appearance of CT in microelectrode guided thalamotomy and posteroventral pallidotomy for treatment of Parkinsons disease.Methods To locate with CT in 180 patients with Parkinsons disease before surgery and compare CT loculization and the target of microelectrode electrophysiological recording.All patients had CT scans within 24 hours after surgery,10 of whom had CT scans within 6～8 months.Results ①The coincident rate of CT with intraoperative target was 34%,the rate of modification was 66%,and the size of modification was 2±1.5mm.②Postoperative CT findings:The destroyed area and periphery edema were both in low density with unclear bondary,and 180 cases had edema extending into the internal capsule,of which had edema extending into the optic tract.The average size:For one destroyed target,it was 486±108mm 3;For two destroyed targets,it was 977±234mm 3;For 10 cases within 6～8 months after surgery,the size was 29.5±19.8mm 3.③Postoperative complications:There were 14 cases who had hemorrhage 10 in the destroyed targets and 4 in puncture tunnels.Conclusion The accurate localization of CT imaging is the key point to the success of operation and low complications.The postoperative imagings are important index to evaluate the surgery for treatment of Parkinsons disease.

关 键 词：微电极记录技术 手术治疗 帕金森病 CT 影像学评价 

分 类 号：R816.1[医药卫生—放射医学]