苍白球腹后部毁损术中的靶点解剖定位和电生理定位  

The anatomical and electrophysiological target localization when performing posteroventral pallidotomy

作　　者：胡小吾[1] 周晓平[1] 王来兴[1] 姜秀峰[1] 金爱国[2] 曾浩[2] 徐波涛[1] 张鑫[1] 

机构地区：[1]第二军医大学长海医院神经外科,上海200433 [2]第二军医大学长海医院MRI室,上海200433

出　　处：《中华神经外科杂志》2003年第4期292-295,共4页Chinese Journal of Neurosurgery

摘　　要：目的总结苍白球腹后部毁损术中的靶点定位方法。方法采用MRI扫描,前50例用坐标定位法计算靶点坐标,平均记录2.6个针道微电极信号;后191例采用坐标定位和图像定位相结合的方法计算靶点坐标,平均记录1.3个针道微电极信号。结果MRI图像能显示苍白球各部分、内囊及视束等结构。微电极记录可确认苍白球内侧部边界、视束等结构。前50例患者坐标调整的百分数明显高于后191例患者。结论MRI坐标定位和图像定位相结合,减少了个体差异引起的误差,使解剖定位更加准确。微电极记录技术是MRI定位方法的必要补充。Objective To optimize the accuracy of the target localization when performing posteroventral pallidotomy in Parkinson's disease.Methods A CRW stereotacti c frame was positioned after local anesthesia,and MRI was performed to get th e middle sagittal image,axial image which was through the AC point and PC poin t,and coronal image which was3mm in front of the midcommissur al point.In ou r first50cases,the target localization was generally based on the coordinate s for the center of globus pallidus internus and2-4microelectrode passes per case (average2.6)were made.But in last191cases,the target localizatio n was based on combination the coordinates with the anatomical localization of t he target site as determined by MRI and only1-2passes per case(average1. 3)were made.Results The MRI allowed visualization the globus pallidus extern us,globus pallidus internus,medullary laminae and optic tract.In our first5 0cases,microelectrode recording led to targeting change more than in last19 1cases.The technique with microelectrode recording provided a precise determin ation of locations of delineation of the ventral border of globus pallidus inter nus.Conclusion The initial target can be determined by combination the coordina tes with anatomical localization.Microelectrode recording provides important t argeting information for performing pallidotomy

关 键 词：帕金森病 苍白球腹后部毁损术 靶点定位 电生理定位 

分 类 号：R651.1[医药卫生—外科学]