基于近红外光谱帕金森病射频毁损术中实时监控技术研究
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摘要
本文主要探索近红外光谱技术在帕金森病射频毁损术中实时监控技术,为将来帕金森病临床治疗射频手术精确监控打下基础,达到减少手术盲目性和提高手术治愈率的目的。论文详细描述了帕金森病射频毁损治疗术近红外光谱技术实时监测实验的具体方法与步骤,在大量大鼠实验基础上,建立了帕金森病射频毁损手术靶点近红外光谱光学参数(约化散射系数'μs,吸收系数μa)及血氧参数(总血红蛋白浓度Ct Hb、含氧血红蛋白浓度C HbO2、还原血红蛋白浓度C Hb和血氧饱和度SO2 )与射频参数(射频温度(T)及射频持续时间(t))的数学模型。这些数学模型表明治疗靶点的脑组织近红外光谱参数确实能够反映术中治疗效果,并且光学参数μs'可以比较准确地作为帕金森治疗射频毁损手术实时监控因子,论文通过大鼠实验充分证明了近红外光谱技术在帕金森病治疗射频术中实时在位监控中的可行性。
论文主要创新点:(1)提出了一种基于近红外光谱的帕金森病射频毁损术中实时监控技术; (2)利用微创近红外光谱组织参数实时在位监测系统进行了的动物实验,得出能够反映毁损手术疗效的近红外评估因子;(3)建立了疗效评估数学模型,实现了近红外光谱技术进行射频毁损实时监控过程。
Main goal of this study is to explor the application of Near Infrared Spectroscopy (NIRS) technique for realtime monitoring technique in Radiofrequency (RF) surgery for Parkinson’s disease (PD), it can help to reduce the blindness of surgery and improve the cure rate. Methods and procedures of the RF surgery experiment for PD are expounded. Based on the great amount of rats experiments, the relationships models between the optical parameters ( reduced scattering coefficient:μs', absorption coefficient :μa) and hemoglobin oxygen parameters(total hemoglobin concentration: Ct Hb,oxy-hemoglobin concentration: C HbO2, de-oxy-hemoglobin concentration: C Hb and hemoglobin oxygen saturation: SO2 ) of target brain tissue and radiofrequency parameters(temperature :T and lasting time:t ) are established. These models show that the NIRS parameters of the target brain tissue can indeed reflect the effects of RF surgery, and relatively, the parametersμs' can accurately be used as evaluating factors in NIRS realtime monitor. The feasibility of using NIRS in realtime monitoring technique during RF surgery for Parkinson’s disease is confirmed by means of these rats experiments.
The creativeness of this study is as follows: (1) put forward the idea of applying Near Infrared Spectroscopy (NIRS) technique in realtime monitoring technique in RF surgery for Parkinson’s disease, (2) obtain the NIRS evaluating factors which can reflect the change of brain tissue during RF surgery by rats experiments using the minimally invasive NIRS in vivo realtime monitoring system, (3) establish the effects evaluating mathematical models and fulfill the RF surgery monitoring using NIRS.
论文主要创新点:(1)提出了一种基于近红外光谱的帕金森病射频毁损术中实时监控技术; (2)利用微创近红外光谱组织参数实时在位监测系统进行了的动物实验,得出能够反映毁损手术疗效的近红外评估因子;(3)建立了疗效评估数学模型,实现了近红外光谱技术进行射频毁损实时监控过程。
Main goal of this study is to explor the application of Near Infrared Spectroscopy (NIRS) technique for realtime monitoring technique in Radiofrequency (RF) surgery for Parkinson’s disease (PD), it can help to reduce the blindness of surgery and improve the cure rate. Methods and procedures of the RF surgery experiment for PD are expounded. Based on the great amount of rats experiments, the relationships models between the optical parameters ( reduced scattering coefficient:μs', absorption coefficient :μa) and hemoglobin oxygen parameters(total hemoglobin concentration: Ct Hb,oxy-hemoglobin concentration: C HbO2, de-oxy-hemoglobin concentration: C Hb and hemoglobin oxygen saturation: SO2 ) of target brain tissue and radiofrequency parameters(temperature :T and lasting time:t ) are established. These models show that the NIRS parameters of the target brain tissue can indeed reflect the effects of RF surgery, and relatively, the parametersμs' can accurately be used as evaluating factors in NIRS realtime monitor. The feasibility of using NIRS in realtime monitoring technique during RF surgery for Parkinson’s disease is confirmed by means of these rats experiments.
The creativeness of this study is as follows: (1) put forward the idea of applying Near Infrared Spectroscopy (NIRS) technique in realtime monitoring technique in RF surgery for Parkinson’s disease, (2) obtain the NIRS evaluating factors which can reflect the change of brain tissue during RF surgery by rats experiments using the minimally invasive NIRS in vivo realtime monitoring system, (3) establish the effects evaluating mathematical models and fulfill the RF surgery monitoring using NIRS.
引文
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[7] Zhang F, Chen B, Zhao S, et al. Noninvasive determination of tissue optical properties based on radiative transfer theory [J]. Optics & Laser Technology,2004, 36(5): 353~359
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[9] Radhakrishnan H, Liu H, Senapati A K, et al. Determination of hemoglobin oxygen saturation in rat sciatic nerve by in vivo near infrared spectroscopy [J]. Brain Research, 2006, 1098(1): 86~93
[10] Zeng H, McWilliams A and Lam S. Optical spectroscopy and imaging for early lung cancer detection: a review [J]. Photodiagnosis and Photodynamic Therapy, 2004, 1(2): 111~122
[11] Stepp H, Beck T, Beyer W, et al. Measurement of fluorophore concentration in turbid media by a single optical fiber [J]. Medical Laser Application, 2007, 22(1): 23~34
[12] Song L M W K and Wilson B C. Optical Detection of High-Grade Dysplasia in Barrett’s Esophagus [J]. Techniques in Gastrointestinal Endoscopy, 2005, 7(2): 78~88
[13] Jiang H, Marquez G and Wang L. Particle sizing in concentrated suspensions by use of steady-state, continuous-wave photon-migration techniques [J]. Opt Lett, 1998, 23(5): 394~396
[14] Weersink R A, Bogaards A, Gertner M, et al. Techniques for delivery and monitoring of TOOKAD (WST09)-mediated photodynamic therapy of the prostate: Clinical experience and practicalities [J]. J. Photochem. Photobio. B: Biology, 2005, 79(3): 211~222
[15] Yves Roggo, Pascal Chalus, Lene Maurer, et al. A review of near infrared spectroscopy and chemometrics in pharmaceutical technologies [J]. Journal of Pharmaceutical and Biomedical Analysis,2007,44(3): 683~700
[16] M.S.Pattersin, B.Chance, and B.C Wilson. Time resolved transmittance and reflectance for the non-invasive measurement of tissue optical properties[J]. Appl.Opt, 1989, 28: 2331~2336
[17] Hanli Liu, Yulin Song, Katherine L.Worden, et al. Noninvasive Investigation of Blood Oxygenation Dynamics of Tumors by Near-Infrared Spectroscopy[J]. Applied Optics-OT, 2000 , 39(28): 5231~5243
[18] B. Kim, M. R. Ostermeyer, S. L. Jacques, et al. Transurethral giber optics for in-vivo optical property determination: human and animal trials, SPIE Proceedings of Laser-Tissue Interaction VII, 1996, 2681: 303~309.
[19] F. Bevilacqua, D. Piguet, P. marguet, et aj. In vivo local determination of tissue optical properties: applocations to human brain[J]. Appl.Opt. 1999, 38(22),4939~4950
[20]钱志余.近红外图象导航技术在帕金森氏病立体定向手术中的应用研究[D].南京:南京航空航天大学博士论文,2003
[21]刘道宽.帕金森病治疗研究的现状[J].临床神经病学杂志,2003,16(2):65~66
[22]董晓贤.李东柱.张学文教授治疗帕金森病的经验[J].中华实用医学, 2002, 4(23): 46
[23]任汝静,陈生弟.帕金森病的早期诊断[J].诊断学理论与实践杂志, 2004, 4(2): 263~265
[24]陈生弟.我国帕金森病的研究进展[J].中国神经免疫病学和神经病学杂志, 2001, 8(2): 67~68
[25]Schrag A , Kingsley D , Phatouros C , et al . Clinical usef ulnessof magnetic resonance imaging in multiple system at rophy [J]. J. Neurol Neurosurg Psychiat ry, 1998, 65: 65~71
[26]王丽娟,唐安戊,刘斌,等.帕金森病脑18 F-FDG PET显像临床研究[J].中华核医学杂志, 2002, 22: 17~19.
[27]Brucke T, Djamshidian S, Bencsits G, et al. SPECT and PET imaging of the dopaminergic system in Parkinson’s disease[J]. Journal of neurology, 2000 , 247 ( Supplement 4): 2~7.
[28] Fernandez H H, Friedman J H. 18F- Dopa vs dopamine ransporter ligands in positron emission tomographic and single-photon emission computed tomographic scans for Parkinson disease[J]. Arch Neurol, 2002 , 59 : 1973~1974.
[29]Miyasaki JM, Martin W, Suchowersky O, et al. Practice parameter: initiation of treatment for Parkinson's disease: an evidence-based review: Report of the Quality Standards Subcommittee of the American Academy of Neurology [J]. Neurology 2002, 58(1): 7~11
[30]Mai A , Artico M , Esposito M , et al . Synthesis and biological evaluation of enantiomerically pure pyrrolyl-oxazolidinones as a new class of potent and selective monoamine oxidase type A inhibitors [J]. Farmaco, 2003, 58 (3): 231 ~ 241.
[31]Sairam K, Saravanan KS , Banerjee R , et al . Non-steroidal anti-inflammatory drug sodium salicylate, but not diclofenac or celecoxib, protects against 1-methyl-4-phenyl pyridinium-induced dopaminergic neurotoxicity in rats [J]. Brain Research, 2003, 966: 245~252
[32]Calne D , Schulzer M , Mak E , et al . Treatment for the progression of Parkinson’s disease[J]. Lancet Neurol , 2005, 4 (4): 206.
[33] Maruyama W, Akao Y, Carrillo MC, et al . Neuroprotection by propargylamines in Parkinson’s disease : suppression of apoptosis and induction of prosurvival genes[J]. Neurotoxicol Teratol, 2002, 24 (5): 675 ~ 682.
[34]Lingor P, Unsicker K, Krieglstein K. GDNF and NT - 4 protect midbrain dopaminergic neurons from toxic damage by iron and nitric oxide[J]. Exp Neurol, 2000, 163 (1) : 55 ~ 62.
[35]Moresco RM , Volonte MA , Messa C , et al . New perspectiveson neurochemical effects of amantadine in the brain of parkinsonian patients: a PET - [(11) C] raclopride study[J]. J Neural Transm, 2002, 109 (10): 1265 ~ 1274.
[36]Okun Ms, Vitek JL. Lesion therapy for Parkinson’s disease and other movement disorders: update and controversies [J]. MorDisord , 2004, 19 (4) : 3753 ~3789.
[37]Alexander E, III, Kooyh. M. , Van Herk M., et al . Magnetic resonance image-directed stereotactic neurosurgery: use of image fusion with computerized tomography to enhance spatial accuracy[J]. J Neurosurg, 1995, 83 (2) :271~276.
[38]Garonzik IM, Hua SE, Ohara S, et al. Intra operative microelectrode and semi - microelectrode recording during the physiological localization of the thalamic nucleus ventral intermediate [J]. MorDisord, 2002 , 17 (supplement) : 135~144.
[39]胡小吾,周晓平,王来兴,等.刺激术和毁损术在双侧立体定向手术治疗帕金森病中的比较[J].中华神经外科杂志, 2004, 20(4) : 280~282.
[40]Ondo WG, Bronte S. The North American survey of placementand adjustment strategies for deep brain stimulation [J]. Stereotact Funct Neurosurg, 2005, 83 (10):142~147.
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