Research on the subthalamic nucleus localization using 3D-FLAIR MRI in deep brain stimulation for Parkinson's disease
Objective To explore the clinical effect of 3D-FLAIR MRI sequence for targeting the subthalamic nucleus(STN)used in the deep brain stimulation(DBS)for the treatment of Parkinson's disease(PD).Methods A prospective study was conducted on 40 PD patients who underwent bilateral DBS surgery at the Department of Neurosurgery,the First Affiliated Hospital of Harbin Medical University from March 2021 to September 2022.According to simple randomization method,20 patients received T2-weighted image(T2WI)scan to target STN(T2WI group),while the other 20 patients underwent 3D-FLAIR sequence(3D-FLAIR group)scan.The contrast ratio of the STN and its surrounding normal white matter as well as the radial error on the plane parallel to anterior commissure-posterior commissure(AC-PC)plane after electrode implantation were calculated.The baseline data before surgery,the contrast ratio,the score of part Ⅲ of Unified Parkinson's Disease Rating Scale(UPDRS-Ⅲ)after 6 months of surgery and its improvement rate were compared between the two groups.Results There were no significant difference in the gender,surgical age,disease duration,pre-surgical UPDRS-Ⅲ score(Med-on,Med-off)between the two groups(all P＞0.05).The contrast ratio of STN and its surrounding normal white matter was higher in 3D-FLAIR group than that in T2WI group(0.48±0.10 vs.0.34±0.11,t=-4.49,P=0.001).In the radial error of implanted electrodes,the UPDRS Ⅲ score(Med-off)or motor score improvement rate at 6 months post turning on of the stimulator,there were no significant differences between the two groups(all P＞0.05).Conclusion In pre-surgical localization of the STN on MRI,the electrode implantation accuracy and clinical efficacy after DBS of the 3D-FLAIR and T2WI groups were comparable,but the contrast between STN and the surrounding white matter was higher and the STN was easier to identify by 3D-FLAIR.
万方数据
维普
