高分辨率3D CE-MRV联合3D T1增强在SEEG手术计划中的应用
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摘要
目的:探讨利用高分辨率3D CE-MRV联合3D T1增强在SEEG手术计划的可行性及准确性。方法:对计划行SEEG手术的12例药物难治性癫痫患者进行定制的MRI检查,利用iplan软件制定手术计划,共植入89根电极,分析手术结果。结果:12例患者共89根电极均顺利植入,术后未发生出血。其中包括2例岛叶癫痫的患者。结论:高分辨率3D CE-MRV有助于寻找无血管通道,3D T1增强有助于了解针道所经过的脑组织结构,两者联合使用可以准确地制定手术计划,减少手术并发症。
Objective:To investigate the feasibility and accuracy of high-resolution three-dimensional contrast-enhanced magnetic resonance venography(3D CE-MRV)combined with three-dimensional T1-weighted magnetic resonance imaging(3D T1-weight MRI)in surgical planning for stereotactic electroencephalography. Methods:A total of 12 patients with medically intractable epilepsy who planned to undergo SEEG surgery were enrolled. Individualized MRI was performed,and the i Plan software was used to develop surgical plans. A total of 89 electrodes were implanted,and the results of the surgery were analyzed. Results:The 89 electrodes were successfully implanted,and no postoperative bleeding was observed. Of all patients,2 had insular epilepsy. Conclusion:High-resolution 3D CE-MRV helps to find the avascular trajectory and 3D T1-weight MRI helps to know the structure of brain tissue in the avascular trajectory. Their combination can accurately develop the surgical plan and reduce complications.
Objective:To investigate the feasibility and accuracy of high-resolution three-dimensional contrast-enhanced magnetic resonance venography(3D CE-MRV)combined with three-dimensional T1-weighted magnetic resonance imaging(3D T1-weight MRI)in surgical planning for stereotactic electroencephalography. Methods:A total of 12 patients with medically intractable epilepsy who planned to undergo SEEG surgery were enrolled. Individualized MRI was performed,and the i Plan software was used to develop surgical plans. A total of 89 electrodes were implanted,and the results of the surgery were analyzed. Results:The 89 electrodes were successfully implanted,and no postoperative bleeding was observed. Of all patients,2 had insular epilepsy. Conclusion:High-resolution 3D CE-MRV helps to find the avascular trajectory and 3D T1-weight MRI helps to know the structure of brain tissue in the avascular trajectory. Their combination can accurately develop the surgical plan and reduce complications.
引文
[1]Cardinale F,Casaceli G,Raneri F,et al.Implantation of stereoelectroencephalography electrodes:a systematic review[J].J Clin Neurophysiol,2016,33(6):490-502.
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[6]潘璟琍,张道春,丁建荣.高分辨CE-MRV对颅内静脉系统的显示[J].医学影像学杂志,2011,21(2):175-177.
[7]Liu W,Guo H,Du X,et al.Cortical vessel imaging and visualization for image guided depth electrode insertion[J].Comput Med Imaging Graph,2013,37(2):123-130.
[8]Cardinale F,Pero G,Quilici L,et al.Cerebral angiography for multimodal surgical planning in epilepsy surgery:description of a new three-dimensional technique and literature review[J].World Neurosurg,2015,84(2):358-367.
[9]Yigˇit H,Turan A,Ergün E,et al.Time-resolved MR angiography of the intracranial venous system:an alternative MR venography technique[J].Eur Radiol,2012,22(5):980-989.
[10]Minkin K,Gabrovski K,Penkov M,et al.Stereoelectroencephalography using magnetic resonance angiography for avascular trajectory planning:technical report[J].Neurosurgery,2017,81(4):688-695.
[2]Mullin JP,Shriver M,Alomar S,et al.Is SEEG safe?A systematic review and meta-analysis of stereo-electroencephalography-related complications[J].Epilepsia,2016,57(3):386-401.
[3]Mirzayan MJ,von Roden M,Bulacio J,et al.The usefulness of intraoperative cerebral C-Arm CT angiogram for implantation of intracranial depth electrodes in stereotactic electroencephalography procedure[J].Stereotact Funct Neurosurg,2016,94(1):10-17.
[4]Cardinale F,Cossu M,Castana L,et al.Stereoelectroencephalography:surgical methodology,safety,and stereotactic application accuracy in 500 procedures[J].Neurosurg,2013,72(3):353-366.
[5]刘烁,林光耀,蒋杰,等.颅内静脉窦2D-TOF MR和3D-CE MRA扫描方法对比研究[J].磁共振成像,2015,6(3):178-181.
[6]潘璟琍,张道春,丁建荣.高分辨CE-MRV对颅内静脉系统的显示[J].医学影像学杂志,2011,21(2):175-177.
[7]Liu W,Guo H,Du X,et al.Cortical vessel imaging and visualization for image guided depth electrode insertion[J].Comput Med Imaging Graph,2013,37(2):123-130.
[8]Cardinale F,Pero G,Quilici L,et al.Cerebral angiography for multimodal surgical planning in epilepsy surgery:description of a new three-dimensional technique and literature review[J].World Neurosurg,2015,84(2):358-367.
[9]Yigˇit H,Turan A,Ergün E,et al.Time-resolved MR angiography of the intracranial venous system:an alternative MR venography technique[J].Eur Radiol,2012,22(5):980-989.
[10]Minkin K,Gabrovski K,Penkov M,et al.Stereoelectroencephalography using magnetic resonance angiography for avascular trajectory planning:technical report[J].Neurosurgery,2017,81(4):688-695.