帕金森病脑深部电刺激电极术后位置规律分析  

Imaging law of postoperative electrode locations in deep brain stimulation for Parkinson’s disease

作　　者：王滔[1] 张陈诚[1] 李殿友[1] 孙伯民[1] 傅萌[2] WANG Tao;ZHANG Chen-cheng;LI Dian-you;SUN Bo-min;FU Meng(Department of Functional Neurosurgery,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Department of Radiology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院功能神经外科,上海200025 [2]上海交通大学医学院附属瑞金医院放射科,上海200025

出　　处：《上海交通大学学报（医学版）》2020年第1期64-69,共6页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海交通大学医学院-中国科学院神经科学研究所脑疾病临床研究中心;国家自然科学基金（81771482）~~

摘　　要：目的·探讨经脑深部电刺激(deep brain stimulation,DBS)治疗帕金森病(Parkinson's 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(P=0.021),左侧电极的空间差距为1.28(0.99,1.88)mm(P=0.006)。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。Objective·To explore the potential regularity and cause of the differences between magnetic resonance imaging(MRI)and computed tomography(CT)presenting electrodes after deep brain stimulation(DBS)for Parkinson's disease(PD),in order to 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 from Jan.2016 to Dec.2017 were selected.CT images were acquired 3-5 days after surgery and MRI images were acquired during 3-6 months by the 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 difference by the 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(P=0.021)and 1.28(0.99,1.88)mm(P=0.006),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.

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 

分 类 号：R651.1[医药卫生—外科学]